lavette43 75 Posted July 22, 2022 I went through the same thing a few months ago due to a hiatal hernia that had become almost strangulated. The 'reason' for my surgery was hernia repair, and that is what the insurance company approved. As my surgeon said, "we went in to fix the hernia and a bypass just happened". How is your weight loss coming along ?Sent from my SM-G991U using BariatricPal mobile app Share this post Link to post Share on other sites
I♡BypassedMyPhatAss♡ 804 Posted July 22, 2022 3 minutes ago, lavette43 said: I Was hoping I would bypass all of that... Sent from my SM-G991U using BariatricPal mobile app Oh I was hoping for the same. It really depends on what your insurance requirements are and what your surgeon or clinic requires. My insurance only required six visits with my clinic and I've been a patient there for 4 years, so technically I had already met the insurance requirements... BUT the clinic required a pre op info session, psych eval, and various lab tests. Time passed quickly tho. I think it took me about five months from first appointment for revision until surgery day. Best wishes! 1 lavette43 reacted to this Share this post Link to post Share on other sites
Dogmom68 135 Posted July 22, 2022 All my paperwork was submitted today to my insurance company to get the prior authorization needed for my surgery. I talked to my insurance company yesterday to make sure the bypass was a covered benefit and (thank you Jesus) it is. Because I’m having a revision from VSG to RNY a lot of my requirements had already been met. I had the VSG 18 months ago so I’ve kept up with all my post op appointments with the dietitian since then. My psych evaluation can be used from the VSG surgery for the RNY. I just had my endoscopy this past Tuesday. The only thing left is the prior authorization and I feel pretty confident I’ll be approved based on my medical diagnoses (GERD, hiatal hernia, sleep apnea…) I start my liquid diet on Monday. Only two weeks to go!!!😬 Share this post Link to post Share on other sites
jenuinelygenuinely 81 Posted July 25, 2022 On 7/22/2022 at 2:33 PM, Dogmom68 said: All my paperwork was submitted today to my insurance company to get the prior authorization needed for my surgery. I talked to my insurance company yesterday to make sure the bypass was a covered benefit and (thank you Jesus) it is. Because I’m having a revision from VSG to RNY a lot of my requirements had already been met. I had the VSG 18 months ago so I’ve kept up with all my post op appointments with the dietitian since then. My psych evaluation can be used from the VSG surgery for the RNY. I just had my endoscopy this past Tuesday. The only thing left is the prior authorization and I feel pretty confident I’ll be approved based on my medical diagnoses (GERD, hiatal hernia, sleep apnea…) I start my liquid diet on Monday. Only two weeks to go!!!😬 I also have severe GERD and my endoscopy showed a twist in the middle of my sleeved stomach! Which causes mild obstruction. My surgeon told me the surgery failed me and a revision is needed to get it fixed. I started the new bariatric program with a different hospital March 2021 and my surgery is scheduled for August 29th. Are you on a strict clear liquid diet? 1 Dogmom68 reacted to this Share this post Link to post Share on other sites
Dogmom68 135 Posted July 25, 2022 10 hours ago, jenuinelygenuinely said: I also have severe GERD and my endoscopy showed a twist in the middle of my sleeved stomach! Which causes mild obstruction. My surgeon told me the surgery failed me and a revision is needed to get it fixed. I started the new bariatric program with a different hospital March 2021 and my surgery is scheduled for August 29th. Are you on a strict clear liquid diet? Hi! I’m so sorry about your obstruction!! Holy moly! My surgeon said my sleeve failed me, as well, so I’m having the revision 8/8. Im not on Clear Liquids but I did start my liquid diet today! Im looking forward to moving on with my weight loss and getting rid of this horrible acid reflux! 1 jenuinelygenuinely reacted to this Share this post Link to post Share on other sites
Dogmom68 135 Posted August 2, 2022 Well, I’m pretty disheartened. My surgery was pushed from 8/8 to 8/29 to give my doctor’s office time to resubmit paperwork for an authorization for a hiatal hernia repair. My insurance didn’t approve the bypass revision so I may have to pay that portion of the surgery myself. I had already started my pre-op liquid diet so now that’s on hold for a few more weeks. I was so ready to have my surgery next Monday and now I just feel disappointed and frustrated. If I could afford to pay for the entire surgery, I would just to avoid the hoops I’m having to jump through to get this approved. I could use some words of encouragement right about now. 😢 1 jenuinelygenuinely reacted to this Share this post Link to post Share on other sites
CDMC1972 4 Posted August 2, 2022 16 minutes ago, Dogmom68 said: Well, I’m pretty disheartened. My surgery was pushed from 8/8 to 8/29 to give my doctor’s office time to resubmit paperwork for an authorization for a hiatal hernia repair. My insurance didn’t approve the bypass revision so I may have to pay that portion of the surgery myself. I had already started my pre-op liquid diet so now that’s on hold for a few more weeks. I was so ready to have my surgery next Monday and now I just feel disappointed and frustrated. If I could afford to pay for the entire surgery, I would just to avoid the hoops I’m having to jump through to get this approved. I could use some words of encouragement right about now. 😢 A delay doesn't mean denial. Although, you may feel disheartened at the moment, everything happens for a reason. I wish you much success on your journey. This is just one obstacle to overcome before you get to the finish line. It will get better! 1 Dogmom68 reacted to this Share this post Link to post Share on other sites
jenuinelygenuinely 81 Posted August 2, 2022 56 minutes ago, Dogmom68 said: Well, I’m pretty disheartened. My surgery was pushed from 8/8 to 8/29 to give my doctor’s office time to resubmit paperwork for an authorization for a hiatal hernia repair. My insurance didn’t approve the bypass revision so I may have to pay that portion of the surgery myself. I had already started my pre-op liquid diet so now that’s on hold for a few more weeks. I was so ready to have my surgery next Monday and now I just feel disappointed and frustrated. If I could afford to pay for the entire surgery, I would just to avoid the hoops I’m having to jump through to get this approved. I could use some words of encouragement right about now. 😢 Did your insurance have an option to appeal?!?? I would appeal right away! I feel like a Hiatal Hernia is a reason for a revision. Praying everything goes smooth and this storm will pass! You got this!! 1 Dogmom68 reacted to this Share this post Link to post Share on other sites
Starwarsandcupcakes 2,070 Posted August 2, 2022 On 7/20/2022 at 11:34 AM, lavette43 said: Just waiting to see if my insurance is going to approve it...Question did you have to go back threw everything. Like at the beginning of your surgery. Sent from my SM-G991U using BariatricPal mobile app I think it depends on when your last WLS was and your surgeon/insurance. I know I had to do the 2 week pre-op liquid diet again for my revision (due to gerd and hiatal hernia of almost my entire gastric sleeve) but I didn’t have to do the nutritional appts or the 6 month preop again because it was within a yr of my VSG. Share this post Link to post Share on other sites
Dogmom68 135 Posted August 2, 2022 On 08/02/2022 at 00:51, jenuinelygenuinely said: Did your insurance have an option to appeal?!?? I would appeal right away! I feel like a Hiatal Hernia is a reason for a revision. Praying everything goes smooth and this storm will pass! You got this!! Yes, my doctor is deciding whether or not to appeal or just submit a new request for authorization for repair to my hiatal hernia (and I self pay the bypass portion.) I have BCBS and they said my revision was not medically necessary. I’m afraid if my doctor submits paperwork for an appeal (and the whole thing gets denied again) then that’s the end of the road for me. I don’t mind paying the bypass portion since it’s very doable ($2600.) I almost feel like the hernia repair is more likely to be authorized. What do you think?? Share this post Link to post Share on other sites
jenuinelygenuinely 81 Posted August 3, 2022 9 hours ago, Dogmom68 said: Yes, my doctor is deciding whether or not to appeal or just submit a new request for authorization for repair to my hiatal hernia (and I self pay the bypass portion.) I have BCBS and they said my revision was not medically necessary. I’m afraid if my doctor submits paperwork for an appeal (and the whole thing gets denied again) then that’s the end of the road for me. I don’t mind paying the bypass portion since it’s very doable ($2600.) I almost feel like the hernia repair is more likely to be authorized. What do you think?? It is most definitely medically necessary for a hernia repair. I am so so sorry you're going through this! GERD is definitely something you should get "repaired" GERD can cause esophagus cancer in the future if its more severe. 1 Dogmom68 reacted to this Share this post Link to post Share on other sites
OtterBot 3 Posted August 4, 2022 For those of you that had GERD issues, how soon did they start post surgery? I had GERD prior to surgery (7/29) but still opted for the sleeve. My doc warned me. But I’ve been on PPI’s for so long I’m hopeful it can continue to be managed. Share this post Link to post Share on other sites
Tomo 1,194 Posted August 4, 2022 For those of you that had GERD issues, how soon did they start post surgery? I had GERD prior to surgery (7/29) but still opted for the sleeve. My doc warned me. But I’ve been on PPI’s for so long I’m hopeful it can continue to be managed. Mine took quite a few years. After that it was like gurgling acid in my sleep and a burning esophagus day on and day out. When you can't sleep, one tend to eat for energy. That didn't help my weight loss. It was horrible. I had a revision last August, and I feel so much better. 3 Dogmom68, tabquick2 and jenuinelygenuinely reacted to this Share this post Link to post Share on other sites
Dogmom68 135 Posted August 6, 2022 08/04/2022 11:25 AM, OtterBot said: For those of you that had GERD issues, how soon did they start post surgery? I had GERD prior to surgery (7/29) but still opted for the sleeve. My doc warned me. But I’ve been on PPI’s for so long I’m hopeful it can continue to be managed. I started to have GERD symptoms about six months after my VSG. They’ve continued to worsen and now bother me in my sleep a lot. Even though I take esomeprazole in the AM and Pepcid in the PM. To be honest, I wish I would have just had the bypass to begin with! I only lost about 40 to 50 lbs with my sleeve, as well. I still have 50 to 60 lbs to lose so hopefully once I can get my hiatal hernia repaired and the bypass done then I’ll be able to work on losing that extra weight! 🤞🏻😁💕 1 1 Tomo and jenuinelygenuinely reacted to this Share this post Link to post Share on other sites
lolarose13 147 Posted August 6, 2022 On 08/01/2022 at 23:49, Dogmom68 said: Well, I’m pretty disheartened. My surgery was pushed from 8/8 to 8/29 to give my doctor’s office time to resubmit paperwork for an authorization for a hiatal hernia repair. My insurance didn’t approve the bypass revision so I may have to pay that portion of the surgery myself. I had already started my pre-op liquid diet so now that’s on hold for a few more weeks. I was so ready to have my surgery next Monday and now I just feel disappointed and frustrated. If I could afford to pay for the entire surgery, I would just to avoid the hoops I’m having to jump through to get this approved. I could use some words of encouragement right about now. 😢Hi! do you mind telling me what your insurance is? I have Aetna, and I have a feeling this is going to happen with me since I have GERD and EGD only showed a Hiatal hernia. Share this post Link to post Share on other sites