My surgeon explained it is where they fold the stomach and suture along with the band. Sort of a band sleeve combo, but reversible. He stated they have been doing in in Australia for yrs with great success. He said it greatly reduces the possibility of band complications, such as slippage. I will be part of a study group and am anxious to get feed back of anyone who has had it.
For everyone that stated true results over charged their insurance, please understand that there is difference between "billed" charges and a "negotiated" rate. Meaning true results may bill for any amount, but your carrier will only pay what has been negotiated . For example true results bills $32,000 but their negotiated rate with your insurance carrier is $ 8,000.....they are only going to receive the
$ 8,000 and can not balance bill the patient.
I forgot to add the part pulled from bulletin :/
Member has attempted weight loss in the past without successful long-term weight reduction; and
Member must meet either criterion 1 (physician-supervised nutrition and exercise program) or criterion 2 (multi-disciplinary surgical preparatory regimen):
Make yourself familiar with their clinical policy bulletin on weight loss surgery and build your appeal based on that.
I was told I may not qualify by my surgeon, but I researched and provided my own argument with my submission and was approved on my first attempt. I also worked at Aetna for many years and was familiar with their process.
Here is an excerpt from the bulletin, this is what I would start with.
http://www.aetna.com/cpb/medical/data/100_199/0157.html