Ins Denied my Revision... help!

[dmia 1]

I am in the process of trying to get my lap band removed and revised to the sleeve. My insurance company was agreeable and said that I needed to have another psyche eval and 3 mos of nutritional counseling, with which I did comply. My insurance company is First Choice through the ILWU... which is fantastic insurance, but they referred this claim out to Innovation Care Management for review. I have had my band for 6 years and I initially lost 70 lbs. and pretty much stayed at about a 60 lb loss until about a year ago. I had only a little over 3cc of Fluid in my band and could barely eat any solid food.... mostly Soups, shakes... nothing with any substance. My reflux is off the charts, having to sleep propped and taking the strongest dosage of meds twice daily. I can't eat much of any solid food without it coming back up. I had pretty much had convinced myself that this was the way my life was going to be , but after a conversation with dr. he came to the conclusion that my band had failed. After my consideration, I have chosen to have the sleeve, however my BMI is just at 35. While waiting for my approval, all of the fluid was removed from my band to help me heal before surgery. I have been able to eat a little better, but still not a lot of solid food. My reflux is pretty much the same.... I have gained 20 pounds and my blood pressure is vasilating and my BMI is rising . I was anxiously waiting to get my approval for surgery. The ICM doctor said since I was managing with the unfilled band, its better for me to just live with it like it is! My doctor had a peer to peer conversation with him and I still was denied! I need to file an appeal.... I read on here where someone had some info regarding appeals... letters, etc. Can you help a girl out? What a way to spend the holidays! Thanks!

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[LipstickLady 25,682]

I can't help you with an appeal in any way, but if you have severe reflux, you should ask about bypass vs. sleeve.

I love my sleeve, but from what I understand, it only exacerbates the GERD issue. Most people who have it are better candidates for bypass.

[Aggiemae 739]

Focus on the reflux instead of the weight gain. And be aware that people with hardware not good candidates for the sleeve.d