Taunter 15 Posted September 5, 2017 I've been on the road to revision from Band to RNY since October 2015. It's a loooong story. Here are the best parts: After finally qualifying with my surgeon for revision surgery in November 2016, I was denied coverage by my insurance carrier (BCBS IL) on 11/30/2016. My surgeon did a peer-to-peer review on 2/1/2017 which was denied as well. Since I only had 180 days from the original denial to file an appeal, I knew I had to do something drastic. In April I hired Kelley & Walter Lindstrom from the LINDSTROM OBESITY ADVOCACY group. They're lawyers who have specialized in WLS appeals. From April to June we had to go through a 2nd level of appeals which was again denied. At the end of July, my case finally went to an external review board. I received my official approval on September 1st, 2017!! Throughout this whole process, Kelley has stayed in close contact - keeping me apprised of each step and calming my fears. When I first applied to them she told me they would only accept my case if they thought they could make a difference. Both her and her husband were so helpful and caring. They have a real passion for helping people get the WLS they need. If you're having issues with your insurance company, please consider them. I think you'll be very happy with the results! http://wlsappeals.com/ https://www.facebook.com/LindstromObesityAdvocacy/ 1 SIPS in Seattle reacted to this Share this post Link to post Share on other sites
SIPS in Seattle 345 Posted September 5, 2017 I've been on the road to revision from Band to RNY since October 2015. It's a loooong story. Here are the best parts: After finally qualifying with my surgeon for revision surgery in November 2016, I was denied coverage by my insurance carrier (BCBS IL) on 11/30/2016. My surgeon did a peer-to-peer review on 2/1/2017 which was denied as well. Since I only had 180 days from the original denial to file an appeal, I knew I had to do something drastic. In April I hired Kelley & Walter Lindstrom from the LINDSTROM OBESITY ADVOCACY group. They're lawyers who have specialized in WLS appeals. From April to June we had to go through a 2nd level of appeals which was again denied. At the end of July, my case finally went to an external review board. I received my official approval on September 1st, 2017!! Throughout this whole process, Kelley has stayed in close contact - keeping me apprised of each step and calming my fears. When I first applied to them she told me they would only accept my case if they thought they could make a difference. Both her and her husband were so helpful and caring. They have a real passion for helping people get the WLS they need. If you're having issues with your insurance company, please consider them. I think you'll be very happy with the results!http://wlsappeals.com/https://www.facebook.com/LindstromObesityAdvocacy/They helped me years ago when I was denied my band. They're great. Band to SIPS/SA-DI/LOOP DS 8.8.17HT: 5'6ish HW: 242 SW: 226 CW: 206 GW: Healthy 1 Taunter reacted to this Share this post Link to post Share on other sites
sundevilde 1 Posted September 20, 2017 I didn't know they were still around! I too have BCBS IL. I had lap band removed in July. Now going through process for RNY surgery. My doctor didn't want to do it at the same time. Hoping I don't have an issue getting approved but if I do I may hire them! May I ask how much they charge? Thanks! Did you get your surgery date? Good luck to you, what a long process you have been through! Share this post Link to post Share on other sites
Taunter 15 Posted September 20, 2017 31 minutes ago, sundevilde said: I didn't know they were still around! I too have BCBS IL. I had lap band removed in July. Now going through process for RNY surgery. My doctor didn't want to do it at the same time. Hoping I don't have an issue getting approved but if I do I may hire them! May I ask how much they charge? Thanks! Did you get your surgery date? Good luck to you, what a long process you have been through! Hello there! They have a couple of rates depending on how quickly you need something done. I can tell you what they quoted me but can't guarantee the rates will stay the same. To me it was completely worth it to get the Insurance company to pay. It was $900 for regular service (which covers going through all internal appeals with an insurance company and any external reviews) and $1200 for expedited service (which I needed because I was close to the end of my 180 day appeal period). Again, HIGHLY recommend! Share this post Link to post Share on other sites
sundevilde 1 Posted September 21, 2017 Thanks! I will consider it for sure if I don't get approved. I think I only get 1 or 2 appeals. Share this post Link to post Share on other sites