RayLandry

Dr, Snow in Trophy Club.

Lindstrom Healthcare Advocacy fought and won for me! An approval after two appeals! LHA rocks! Thanks Walter and Kelley!

Hello y'all! I just wanted let anyone, who is being denied by their insurance company, to consider Lindstrom Healthcare Advocacy, to help in your fight for approval or overturning a previous denial! My story.... I was denied coverage for revision surgery (lapband to sleeve) twice, by insurance xyz (I am not naming insurance company, until I get reimbursed), and enlisted Lindstrom Healthcare Advocacy for 3rd appeal and subsequently, a review by an independent doctor. After a few months of diligent and expert advocacy, on my behalf, LHA convinced the doctor and insurance xyz to finally approve my surgery! And this was almost 3 months AFTER my surgery, in which I funded myself! I am just waiting on reimbursement, which is in works now. I've talked to my insurance company and they are keeping me updated in the whole process. They have assured me that I am covered and reimbursement is in the making. Just a matter of claims and paperwork from my providers. Walter and Kelley Lindstrom, makeup the army that fights the good fight for you, by way of expert letters, phone calls, and legal knowledge. These guys are lawyers, who have made their primary scope, that of advocating healthcare, for those who need it. Insurance companies, in many cases, will use a multitude of reasons for denying coverage! In my case, insurance xyz was denying my coverage, due to a clause in our policy, that allows only one lifetime bariatric surgery. Walter Lindstroms letters and provided facts, convinced that my revision was not only necessary, but also eligible for coverage. Regardless of clause in policy. Kelley Brown Lindstrom, does ALL the leg work, as far as medical records and release forms. I can't say enough about her help and willingness to listen and answer all questions! She is simply genuinely awesome! As for the cost, it amounted to about 10% of the cost of my surgery. A risk indeed, but nonetheless, worth it. I will be getting back, minus deductibles and out of pocket maximums, about 90% of my total surgery cost! Three months AFTER my self paid surgery! My revision surgery was worth my self funding, regardless of an approval or not. I am now only 15 pounds from my goal weight, in just 16 weeks out of surgery! But with the help of Lindstrom Healthcare Advocacy, the victory is just that much more sweeter!

Like most things, you just never know until you try. I just self paid for my revision because my insurance denied removal and revision. They deemed it “medically unnecessary “. I am on my second appeal, with the help of an outside advocacy firm. I am praying this works to get me reimbursed! I too had the problems of reflux, pain, and night coughs. As a result, my esophagus was getting irritated. I am 18 days out from revision surgery and I feel great! Reflux is gone and I have already lost about 26 lbs! My BMI, at time of surgery was about 33. Not your typical 40+, like most bariatric surgery candidates. Good luck to you Kerri, hopefully you can get your insurance to pay for it! Believe me, I know firsthand, the negative outcomes of lapband!

I can see the probability of some kind of addiction! Thanks

Thanks guys!

Best of luck to ya!

Thanks....4 months. I may NOT need it! I KNOW, that I will pay better golf!

fingers are crossed!

Ha! Great point Jazzy! Never thought of that! Ray

Thanks for the advice guys. I dig y'alls passion and commitment! It's evident that y'all are winning the battle of obesity. I should have made my question a little more clearer. I totally understand that alcohol equals useless calories and can lead to poor choices in general, namely food consumption! I was referring to the sleeve itself, and the potential harm that alcohol could have on the healing sutures and such. As of now, I am self funding my revision (appeal in progress), so I am in no way planning to waste my hard earned money and sabotage my potential success. But having said that, I still want a life! I am a very light drinker and may go months without nary a drop. There are times and occasions that I like to be social and partake in the "party". That's all. Thanks, Ray

Howdy, I am getting sleeved (revision, Band to Sleeve) in a couple of weeks. I have a question. I am an avid golfer and my buds from work and I, take a couple of golf trips a year. Usually to Myrtle Beach. Usually 4-5 days of golf and beer! We have a blast! Well, as much of a blast that 50 somethings can have. LOL . Our next outing is in late April and I am wondering how I will handle this! So, my question is this.......how is alcohol consumption after VGS? Is beer off limits? Thanks, Ray

Well, I'm not sure if I am throwing good money after bad, but I just enlisted Lindstrom Obesity Advocacy to for a second appeal! Thanks Jenn for the recommendation. We'll see what happens! The cost of the assistance and advocacy vs. The surgery costs......well, it's a no brainer! I just hope that I didn't dig myself a deeper hole! Thanks ya'll

Jenn, thank you for the website! Since my surgery is only about 2 weeks away, do you think it is too late?

I am having my band revision to VGS in a couple of weeks. ON MY DIME! I guess my insurance felt that 2 WLS covered were the max! LOL Background here......Banded in 2005 ( insured), Band slipped and rebanded 2012 (insured), Revision set for 12/27 ( Out of pocket). Insurance denied because of prior surgeries. Oh well screw 'em! I'll pay for #3 my own dang self! Hopefully, with God's grace, this will be the answer!

I was banded back in 2005, then rebanded in 2012 (slippage). I've never really felt the restriction described by others. I did lose weight, but I think it was mainly from being more active and eating less. That's probably what the band is exactly meant for. A tool. Hopefully you will find your sweet spot!

Good luck to all December Sleevers!

Ooops! I mean revision #2! 2005 lapband 2012 band slipped, rebanded 2018 revision to vgs set for 12/27/18 I meant #3 surgery! ?

Band to Sleeve Revision #3, Dec 27! So ready!

BCBS of Texas denied my appeal for lap to sleeve revision also! Even with letters and documentation from my doctors, their policy allows for only one bariatric surgery. Even with documentation about my chronic reflux! Heck with it, I am going self pay in December!

Way to go! High Five! I too am a banded runner.........an addicted runner! I have been running now for about 7months and have worked up to 12-16miles/week! Since being banded, I have ran 10k's, 5k's and a 5 mile race. My longest run so far has been a 7 miler! Last weekend, I flew up to Colorado Springs for a VERY grueling 5 mile run in the Garden Of The Gods! Not being use to the high alltitude and monsterous hills, my goal was just to run the entire 5 miles non-stop and I did it! This was such a grattifying accomplishment, I can't put it into words! Before being banded, I could barely walk around the block without huffing and puffing! It is amaizing what you can do if you stay consistant! My next big goal is to run a half marathon in October. Hopefully I will be close to my 180lb goal weight! ATTENTION LAPBANDERS!!!!! Running is awesome............give it a try and you will make some major gains (losses)!

Good Job Penni! That is a great accomplishment..................be proud of yourself!

well we KNOW Tony isnt going to die......not on the first episode of the season! This years season premier was SO MUCH better than last season's!. It's gonna get goooooood!!

I eat bread all the time! not a whole lot, but I can get down with much chewing!

Hey Carrie.....those injestions Do help relieve the pain. I have a herniated cervical disk and have received 3 injections. They do help! I do lots of neck stretches also! good luck!!