jennifer1

On 3/3/2017 at 10:04 PM, reese711 said:

What were the reasons they denied you for? I'm on my 2nd denial & just keep hoping it will be overturned.

My denials were due to paperwork basicially. Initially i was told the documentation submitted didnt show medical necessity for the removal of my band not that I followed the post op diet and recommendations for the lap band. Next it was because they thought it had been removed in July when in fact it was just totally deflated in July. The peer to peer was denied too, but I never found out why and the last appeal was finally approved! My surgery date is March 14TH!!!!

On 2/8/2017 at 8:38 PM, jennifer1 said:

omg ihave bcbs as well.. i am going for a revision from lap band to vsg.. i started this process in oct 2016.. had everything submitted in Dec.. was denying 3 times and now its in appeals..when i call they just keep saying it looks like they are going to over turn the denial.. but it's still in proces!! AAARRRGGGHH!!!! soooo annoying!!

UPDATE!!! I was finally approved after the appeals process and my surgery date is MARCH 14TH! YEAHHHHH!

i just got through this.. i was denied 3 times for the same reason them stating it wasnt medically necessary. my insurance finally approved me on feb 10th. my insurance company basically stated that due to my band slipping it was deemed medically necessary as this was a fault of the band and not me. Do yo u have any documentation stating any type of mechanical failure with the band?

I just wanted to write this to encourage those who are fighting with insurance for approval. I fought with BCBSIL since Dec 2016 til Feb 2017. I was denied 3 times for various reasons, mostly paperwork crap! Don't give up fighting you are worth it!!!!! Insurance companies look for reasons to say no... dont let them tell you know without giving them the fight of their life!! I felt I have been paying my premiums and co pays for almost 4 years and never had anything major.. soooo they needed to pay for this! LOL!

On 2/2/2017 at 9:03 PM, shortyp79 said:

I'm sure it's just nerves, and i was told with BCBS it takes longer than most other insurance companies, but I'm going nucking futs. Had my initial dr appt in Dec, nut appt Jan 10th, and psych eval Jan 16th.... trying to wait patiently.... i estimated the max of 6 wks being Feb 27th.... 4 wks being Feb 13th. I called BCBS yesterday, and they said my status is still pending.... anybody in this boat with me?

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omg ihave bcbs as well.. i am going for a revision from lap band to vsg.. i started this process in oct 2016.. had everything submitted in Dec.. was denying 3 times and now its in appeals..when i call they just keep saying it looks like they are going to over turn the denial.. but it's still in proces!! AAARRRGGGHH!!!! soooo annoying!!

OK so i was initially submitted to insurance for approval(revision from lapband to vsg) in Dec 2016. I was initially denied because they said I didnt have enough documentation stating it was medically necessary to remove my band nor that I had followed up with the post op diet recommendations after my lap band. I went to meet with my surgeon and he submitted more info per BSBS request. Well they denied it again, this time I was told they thought my band was removed in July 2016.. ummmm no this damn thing is still in me. Sooo they submitted again.. so where along the line a peer to peer happened(which no one even told me we were at that stage), apparently that was denied so now it's in the appeal process!!!

It's been like 2 weeks and still no answer!!! Has anyone ever had to go through all of this I have BCBSIL???? Please tell me there is light at the end of the tunnel.

Has anyone ever done an external appeal?

HELP!!!!

#tiredofbeingfat

#thissucks

#i'msofrustrated

i think you're mentally ready which is an awesome thing! i was like that when i got my lap band.. after the first 3 days..those were rough for me! Keep going!

the first 3 days were the roughest.. be mentally prepared for the head hunger and possible headaches as your body detoxes.. dont shut yourself out from the world..keep yourself busy with things not surrounded around food.. best wishes you can do this!

i have BCBSIL and i saw that about not having to do the 6 month diet, which is true. HOWEVER, i have a lap band and im trying to get it removed and revised to the sleeve. i have been denied twice, basically due to paperwork. they first said my paperwork didnt show it was medically necessary to have my band removed, then we submitted with more paperwork. Now they are saying they thought my band was removed in July so they denied me again!! Currently they are reviewing my paperwork AGAIN!!! So i would just advise that all the documentation they request is submitted correctly!!! Best wishes to you!

I about had a heart attack this morning when I finally got the bill for my surgery.

A bill for 18k.

For about 15 minutes I was frantic, because I had all kinds of insurance problems with my surgery; apparently the doctor was covered, but the hospital wasn't. They managed to work out a deal where the hospital got paid at the in-network rate and I would only have to pay copay + remaining deductible.

Then, something clicked in my head. Copay + remaining deductible -- I should have owed 1800.

Of all the bullshit I went through to get my insurance to cover my surgery, I could think of nothing but the fact that something had gone wrong and I was being held responsible for a huge chunk of the surgery. And what actually went wrong?

Appropriately enough: a fat finger error. BASICALLY, THE DECIMAL POINT WAS IN THE WRONG PLACE.

They're sending me a new bill, for the correct amount thank god. But I had to share, since I'm laughing so hard now.

girl i would have had a heart attack too! glad it was an error!

thats a good question.. i would call your insurance company they will give you a definite answer!

Yeah I know what you mean, I feel like I was in a rush because my deductible is all paid so it would've been basically free this year, but no such luck:/

And that's great! 40 min isn't too bad

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i was rushing to get mine done by the end of 2016 due to insurance as well.. but that didnt happen. now my insurance company denied me but i'm working on getting more paper work submitted!

i have seen those and the flavors look amazing! been too scared to try them i need to research them more.. have you asked your NUT about them?

i wish i would have know the following:

1. achieving and staying in the "green zone" is damn near impossible

2. every adjustment would cost my$250.. so over $1,000 per year

3. that my band tightness would be effected by air pressure..the weather..my period and stress

4. that i cant slack off once i reach goal

5. once my band was emptied...it would NEVER reach the green zone again

6. i wish there were more options for wls when i got the band.

that would be sooooo cool! i asked my surgeon if he would take a pic of my stomach once he removed it. he said yes! LOL

I had my psych eval last week. I thought i was going to be a blubbering mess, but i was so afraid that they would thinkg I wasnt mentally stable enough to have the surgery that I forced myself to hold it together!

Hi has anyone here had a revision from lap band to sleeve at UIC. Specifically with Dr. Hassan.

Fair enough, However, the lap band has been horrible for me I have had it 4 years and have had nothing but complications which has hindered my results. I would never have another surgery if it was anything like the band and I'm sure other Banders with complications would agree on that. That's why It's Important to me to research and become educated on the surgery I choose to have because the band was a tool and it failed I have never been able to eat chicken or turkey veges and have them stay down or even Protein shakes after several adjustment and $$$$ i never had a sweet spot due to continously throwing up my band had slipped defeating the purpose of having it and I again have a hernia, Thats why the tool matters to me. I understand for some they have had great results and no problems with the band that's wonderful

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i have the same fear. i am 95% sure I want a sleeve and then I start thinking what if this doesnt work and I dont lose..I cant do another surgery after this one.. ugh!!!! i am going to do a support group this time and pray that is the key that will help me stay on track..

I have a consultation with Dr. Hollis in Houston tomorrow to see if I can get a band to sleeve revision. I will be self pay since my insurance doesn't cover any bariatrics. Since I will be self pay, does anyone know if I will have to go through all the testing again like I did before I had my lap band put in? Also, does anyone have any idea how much a revision surgery will cost? Thanks.

i was self pay for my lap band and will go through insurance for my sleeve. the price you pay is always much lower than what they charge insurance..which is unfair since i still need to pay 20%..ugh!!! best wishes to you

I personally couldn't get used to the fact that I couldn't eat healthy foods with the band. Things like salads, some vegetables and lean meats were the hardest for me to get down. I had all my fill taken out about 4 years ago and up until last week (when I was sleeved) I would still vomit up certain foods. I hated it.

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ok i thought i was the only one. why is it that healthy foods are hard to get down! UGH!! i have had my band since 2011..it has slipped at least 3 times... currently it is empty and i'm going through the insurance process to get revised to the sleeve! i cant wait to start my new journey!

I had a list of 50 questions for my surgeon... my first question was had ever had an malpracitce suits. Here are a few of my others:

1. What size bougie do you use?

2. Will you be able to use any of the same incisions from my band?

3.What are the worse complications that you have seen occur?

4. What Vitamins are recommended after surgery?/

5. Will I have self adminstered blood thinners after surgery?

6. Will I have JP drain?

7. Will I need an abdominal binder?

8. How much of my stomach will you remove?

9. Do you sew over the staples in the stomach?

10. How frequent are my follow up visits?

Hope some of these help!

i choose Dr. Masrur because he took over my care with my lap band once my orginal surgeon Dr. Elli left and moved to Florida...i finally had my consultation with him last week. I went in with literally 30 questions and he took his time and answered all of them.. i've heard both ways concerning acid reflux that it goes away with the sleeve or lessens of that it stays the same.so i guess it depends on the person.

Hi Jennifer,
I had a consultation at UIC with Dr Pashand last month and I was planning to get the sleeve but he asked me if I am having acid reflux or heartburn. I do once or twice a week, so he said it's not a good idea to get the sleeve because it will make my acid reflux or heartburn worst. Gastric bypass is better choice.
I'm thinking about getting a second opinion.
Did you do any research Dr . Masrur?

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Congrats one getting to the losers bench! I wish you well in your recovery.

Hi I apologize in advance if this topic has been discussed. I have my consultation at UIC in chicago tomorrow. Has anyone had a revision from a band to a sleeve with Dr. Masrur at UIC? If so what was your experience?

Yes, but I've been having problems off and on with a dilated pouch. They think it's time for me to get the sleeve. Common? Being unfilled I can't stay at goal weight no matter what. If they just remove any liquid, I eat like a horse and I put on weight in a hurry. Keep me posted how it goes with your journey through sleeve land. I've done lots of the pre-op testing but still haven't bit the bullet yet. Thanks for the share. You almost got me convinced lol.

I got my band in May 2011..I am in the process of revising to a sleeve. My experience with the band was once I had to have an unfill due to severe vomiting and acid reflux I never could find my sweet spot again. I get what you're saying about getting it adjusting and mot being able to do that with the sleeve, however getting my band adjusted wasnt working anyway right! So sleeve here I come!