lap band removal first to get insurance approval to RNY ?

[offthebandwagon 10]

Hello all,

I had my lap band placed back in march of 2007 when it was all the rage and no proven long term research. I went to surgery at 283, and managed to drop to an all time low of 220 within 10 months. I spent the next 9 years battling with this lapband and all the CRAP that came with it. I remember feeling like I had hit rock bottom when I couldnt even swallow my own saliva, but was slowly seeing the scale creep up. Today I am right back to 274, which is NOT my highest post surgery weight. (I would have never guessed that 9 years ago)

Any how about a year ago, June 2015, I decided something had to give and started seeing a new Dr. about my options. I honestly hadnt see one in years. I had just learned to live with the GERD, upset stomach, inability to eat healthy foods, sleeping sitting up, etc.. I have seen this Dr and his team monthly since June of last year. I have been doing all of the things required by my insurance to meet the criteria for a revision.

When I went to see my surgeon 3 weeks ago, he said we need to go ahead and get the band out asap, since it has been causing me problems. I said GREAT to that and we scheduled my removal date for 7/29/16. woo hoo!!

So then I ask him what about the bypass surgery. He says that will be treated as a completely separate case, and that I was technically on visit #5 of my bcbs required 6 month diet. (the office didn't start to count the visits as diet visits till Jan 2016) not sure why, but okay. His attitude seems to be "Lets get the band out first, and fight with the insurance company later about the revision to rny"

Has anyone else had this type of experience? Im wondering if hes hoping to find something during the surgery, that would lean in favor of the insurance company approving me for a revision. It just seems a little round about...

Thanks everyone for your input

[vita428 33]

Hello all,

I had my lap band placed back in march of 2007 when it was all the rage and no proven long term research. I went to surgery at 283, and managed to drop to an all time low of 220 within 10 months. I spent the next 9 years battling with this lapband and all the CRAP that came with it. I remember feeling like I had hit rock bottom when I couldnt even swallow my own saliva, but was slowly seeing the scale creep up. Today I am right back to 274, which is NOT my highest post surgery weight. (I would have never guessed that 9 years ago)

Any how about a year ago, June 2015, I decided something had to give and started seeing a new Dr. about my options. I honestly hadnt see one in years. I had just learned to live with the GERD, upset stomach, inability to eat healthy foods, sleeping sitting up, etc.. I have seen this Dr and his team monthly since June of last year. I have been doing all of the things required by my insurance to meet the criteria for a revision.

When I went to see my surgeon 3 weeks ago, he said we need to go ahead and get the band out asap, since it has been causing me problems. I said GREAT to that and we scheduled my removal date for 7/29/16. woo hoo!!

So then I ask him what about the bypass surgery. He says that will be treated as a completely separate case, and that I was technically on visit #5 of my bcbs required 6 month diet. (the office didn't start to count the visits as diet visits till Jan 2016) not sure why, but okay. His attitude seems to be "Lets get the band out first, and fight with the insurance company later about the revision to rny"

Has anyone else had this type of experience? Im wondering if hes hoping to find something during the surgery, that would lean in favor of the insurance company approving me for a revision. It just seems a little round about...

Thanks everyone for your input

I had removal and bypass same surgery. Insurance would cover removal if I did it by its own. My band slipped. Even if I waited Yeats they refused to cover RNY. So, I was self pay. I did same visit BC I only get three weeks off per year (they are set ) and price difference was 3000. Got to live insurance but I needed band out due to slip. I was ticking time bomb so to speak. If insurance covers both due it in two surgeries, heard its more effective.

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[offthebandwagon 10]

@@vita428, thanks so much for your input. My insurance will cover a revision if deemed medically neccasary. We shall see what happens Iguess.

[vita428 33]

@@vita428, thanks so much for your input. My insurance will cover a revision if deemed medically neccasary. We shall see what happens Iguess.

Best of luck to you!!! Please keep in touch

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[Bugaboo77 18]

In the same boat. Banded in 2010. Lost 40 lbs at first. Gained it all back due to eating what I could when I was too tight. I started getting a lot of pain so they did a swallow test and band was fine. They let it rest and we put some Fluid back in. I'm having some pain again. Switching doctors. I want to get the band out and maybe do something else, but my insurance won't pay for a revision unless it is medically necessary. Does it sound bad that I'm hoping for some sort of problem to get it out? The doctors that work with lap band around here are few and far between...at least 1 hour away for the nearest doctor to do a fill, and that is only offered 2 days a month. Grrrr....

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