Soli3l 30 Posted August 13, 2015 Good evening, I am unsure if this is the correct forum to post my question, if it's not I apologize ahead of time. I wanted to know if there is a sample letter or template regarding Medical Necessity for VSG Revision due to complications. Such as: Letter from Patient to Health Insurance or Letter from Doctor to Health Insurance. Your assistance is greatly appreciated. Thank you. SoLiEL Share this post Link to post Share on other sites
Pinkgirl1234 761 Posted August 13, 2015 Did you get denied?I am also worried about getting approved.Its like they want you to be fifteen hundred pounds for approval :-( Share this post Link to post Share on other sites
Soli3l 30 Posted August 13, 2015 Did you get denied?I am also worried about getting approved.Its like they want you to be fifteen hundred pounds for approval :-( I have been through the denial process when I was going from lap band to vsg. I called insurance found out reason for denial and then followed the steps with my doctor to get it approved. It is stressful... My Issue right now is that I need revisión surgery but my insurance does not have any bariatric benefits. But any revisión with médical necessity not morbid obesity can be covered. I've got letters from doctors recommending the revision but state morbid obesity and this does not help with my approval as my revision has to get preauth. I'm trying to do the leg work myself because who better than yourself can get the ball rolling? Share this post Link to post Share on other sites
Pinkgirl1234 761 Posted August 13, 2015 So let me get this straight.If you have band slippage or erosion then it's covered.?What about the fact that you are having regain,Gerd,other co morbidies and say you hover around 35 to 40 be I are you able to great revision covered.?What is your insurance? Share this post Link to post Share on other sites
Pinkgirl1234 761 Posted August 14, 2015 Do you need the sleeve revised?if so I am also hearing a lot of people needing sleeve revisions. Share this post Link to post Share on other sites
Soli3l 30 Posted August 14, 2015 So let me get this straight.If you have band slippage or erosion then it's covered.?What about the fact that you are having regain,Gerd,other co morbidies and say you hover around 35 to 40 be I are you able to great revision covered.?What is your insurance?When I had Lap Band and Sleeve I had Cigna, they denied my Sleeve but I appealed with my doctor and got approved. Now I have FL Bcbs but no bariactric benefits so in order to get revision approved their rep said I can mention morbid obesity or any co morbidities, only medical complications to see if I could get it preauth. Share this post Link to post Share on other sites
Soli3l 30 Posted August 14, 2015 Do you need the sleeve revised?if so I am also hearing a lot of people needing sleeve revisions. sounds like but I am having an endoscopy in a couple of weeks to confirm complications Share this post Link to post Share on other sites
Pinkgirl1234 761 Posted August 14, 2015 May I ask you are getting a Revision from sleeve to?i am torn...lapband to??? What's your experience with the sleeve? Share this post Link to post Share on other sites
Soli3l 30 Posted August 14, 2015 May I ask you are getting a Revision from sleeve to?i am torn...lapband to??? What's your experience with the sleeve? my lap band slipped and I couldn't swallow, or keep food down, I got the sleeve done, my new surgeon thinks my lap band stretched the top part of my stomach and my past surgeon didn't cut enough from my stomach....causing technical failure. Otherwise I love my sleeve. Share this post Link to post Share on other sites