Surgery the Hiatal Hernia Route

[jilani 16]

Hello I met my potential surgeon couple of days ago. He said that my insurance (BCBS TX - PPO) requires a criteria approval process but that he can expedite it by going the Hiatal Hernia route. As in get the approval for Hiatal Hernia repair and once he is in there, he can do whatever - i.e. do the gastric sleeve. It seems a bit off the track. I am concerned that if there are any risks afterwards like denial of payment in case of complications due to sleeve if the operation was done under the guise of Hiatal Hernia. Has anyone heard of this? Is this common? What should I do?

[Pepper123 320]

Never heard of this i had a Hernia repaired during my sleeve, but am no doctor and hopefully he knows what he saying and doing.Good luck!!!!

[peteyrulz 82]

This is what I am doing thru Dr. Nicholson in Dallas. I have BCBS FEP and I was denied for the sleeve. They are covering my hernia surgery & I am doing partial payment for the sleeve part.

Is this what your dr wants to do?

[sunshinewhit 0]

I have bcbs fep and in the process of getting approved for sleeve. It would be helpful to know the reason uwere given for denial? ?

[peteyrulz 82]

@@sunshinewhit When I started this adventure in March 2014, my BMI was almost 39 & I didn't have any of the 3 major "accepted" co-morbidities.

[jilani 16]

Yes,peteruiz, I was advised by the surgeon (same as your). My bmi is 48. I do have heartburn so he suggested that .just concerned if there are late complications

[liltextornados2015 4]

@@jilani

How did it go so far for the hernia repair w sleeve? Dr told me i also might have a h hernia repair that might be needed. So just wondering whats happening and in case that happens to me. :/ thank you

Hello I met my potential surgeon couple of days ago. He said that my insurance (BCBS TX - PPO) requires a criteria approval process but that he can expedite it by going the Hiatal Hernia route. As in get the approval for Hiatal Hernia repair and once he is in there, he can do whatever - i.e. do the gastric sleeve. It seems a bit off the track. I am concerned that if there are any risks afterwards like denial of payment in case of complications due to sleeve if the operation was done under the guise of Hiatal Hernia. Has anyone heard of this? Is this common? What should I do?