SusanB55

Congrats! You did it! My husband will be sleeved on May 2. I am pretty nervous for him. I have heard from my Dr's office that the surgery takes about a half hour. Were there complications that made your surgery 4 hours long?

This might date me, but that's what Barney Fife did! He had to pass a weigh in so he wore a heavy metal link chain under his shirt lol!!

Our insurance liason has always said that you must have a BMI of 35 and at least 1 co-morbordity or 40 BMI and no co-morbodity.

Oh no, my surgeon is on board. He wants to do the revision. It's all about the insurance and whether they will approve it. I've seen several posts on here that said their insurance said the revision wasn't medically necessary. That would be a nightmare! All of these appts, time and money just to be heartbroken. Best of luck to you and my hubby on May 2!!!

Oh and lucky us....we get to pay TWO surgeon copays of $200 each. Sheesh.

Our dr supervised WL class is nothing like it sounds lol. We are just told about the surgery, after surgery, what to expect, watch short videos, and a bit of nutrition advice...all by the NP who assists the surgeon,. Never once have i been told to lose weight. Tomorrow is my last NUT and dr supervised and then I should be submitted. My hubby was approved and will be sleeved on may 2. I need a band to sleeve revision and I am super worried that I wil be denied.

Me too!!!!! When is your day? Have you jumped through all the hoops and been authorized?

What insurance do you have? Does Lindstrom charge a lot to help?

That's my husband's surgery date too! Very exciting! He has completed all of his appts with the last one today, the upper endoscopy. He is ready! Maybe they will be able to move up his surgery date, which would be even better. I will have completed my 3 months of jumping through ins/dr hoops tomorrow so my case will be submitted to insurance. My case is a bit different from my hubbies tho. He has many co-morbodities so I knew he'd be approved. I have sleep apnea and BMI of 37, but I also have a band that I want removed and then sleeved, hopefully all at once. I've read sooooooooo many revision stories on here and I would estimate about 50% are denied. I am not feeling very hopeful

Oh boy!! Best wishes to you!

Yes!! Call!!

I know. Everything you both are saying is sensible. I am just an impatient person once the wheels are turning. My husband is being sleeved May 2, or maybe sooner if the surgery can be moved up sooner. I am supposed to follow 3-4 weeks after him, or so that is the plan, lol. Here's the major reason for my impatience and I think any lady and/or mom can relate. My youngest daughter is getting married on August 26 out of state. I need to have surgery ASAP, lose weight ASAP so that I can find a decent dress that will fit me as last minute as possible plus shoes, purse, etc etc. I don't even have decent casual wear and just wear muu-muu type housedresses around the house all day. I don't have one single item of clothing that is decent that I can take along and trying to find clothes that fit me now is horrible. I'm so fat and ugly. And my daughter wants me to walk her down the aisle. Please pray for a fast approval and best conditions so that I can awaken sleeved! Thank you I. am. so. nervous.

This is what I am worried about. BCBS may not think my revision is medically necessary. So the doc is going to have to make the case that I've been vomiting for years and have already had one slipped band (not this current one tho as I had an upper GI-all looks ok) and a hiatal hernia. The other band was replaced under a previous insurance. It is REALLY going to suck when/if my husband has his sleeve and I'm still stuck with the band that is nothing but trouble.What state are u in, bcbs is different in each state. Your story worries me because I have Bcbstx and I'm currently waiting on insurance approval to have my band removed, and revise to the sleeve. Bcbstx does pay for first surgery, 2nd and revisions, they list requirements for each. I meet their requirements for 2nd surgery which would be removal, and I also meet revision if I have slip, dilation or erosion. My surgeon says I have some slip, just don't know if it's enough for them, so I'm still waiting to see what they say, its been 1 week since documents where submitted Sent from my XT1254 using the BariatricPal App

Hi, I'm curious as to what insurance you have that approved the revision? I have BCBS Fed and I'm terrified they will deny me. I have heard that the insurance companies come back saying that the removal/revision is not medically necessary. Altho I do not have a slipped band or a hiatal hernia at this time, I wish I did. Then perhaps my insurance will approve it. Ugh. How are you doing now? You are almost a week out and I hope you are doing well. Let us know

OK, well after reading this thread, I'm not feeling real good about my own chances of: 1. being approved for band to sleeve revision and 2. waking up sleeved as I hope. My surgeon said that he usually does it in 2 surgeries as it is safer. I was pretty upset when I heard this. He said in my case, he would assess the situation when he goes in and if the 'rind' isn't too terrible, he will remove the band and continue with the sleeve. I still have some hurdles to jump. First, insurance authorization and then waking up sleeved.....waaaaaah. Now I'm depressed, lol.

This is what I am worried about. BCBS may not think my revision is medically necessary. So the doc is going to have to make the case that I've been vomiting for years and have already had one slipped band (not this current one tho as I had an upper GI-all looks ok) and a hiatal hernia. The other band was replaced under a previous insurance. It is REALLY going to suck when/if my husband has his sleeve and I'm still stuck with the band that is nothing but trouble.

I know! On one hand, I hate to draw attention to it and on the other hand, I don't want to waste time. But.......I did say on my initial visit to the main insurance/precert gal that I was surprised my surgeon didn't require me to get an endoscopy. She said nope, it's not checked so you don't have to. As for the cardiologist, she said since I am 9 years younger than my hubby (I am 56), I don't need cardiology clearance. I asked if she was sure, lol, and she kinda looked like she was insulted, but oh well. I then brought it up on one of my dr supervised appts who is also the assistant surgeon. He said "everyone" has a to have an endoscopy. I said "really? Everyone.? Well, I don't! " He just made some comments about why I wouldn't have to....it made no sense to me at all, but I guess my point is is that I brought it up on 2 different occasions to 2 different office personnel. Nobody said it must be a mistake so I guess maybe I'm just lucky in that regard. Time will tell! So I am holding my breath come this Thursday when I have my last NUT and dr supervised appts. I will see the insurance gal and tell her I'm ready and to go ahead and submit and see what she says lol.

The insurance should have said why it was denied!! Did anyone tell you why? After all I've read and heard, including numerous phone calls to my BCBS, there is protocol you need to complete prior to submission. You need Nutrition appts with a dietician, dr supervised weight loss appts, and psyche all within a certain amount of time. It varies with different insurance. You have the BMI covered, but sounds like that's all. You have to jump through all the hoops if you want to get approved. I would call insurance myself and ask how you can fix this.

Good luck tomorrow!! I'm going to try and track your posts and progress since my husband is being sleeved May 2 and hopefully me soon after him. I hope everything goes well for you!

What is your BMI?

I am so thankful our surgeon doesn't require a pre-op diet! He demands everything else tho, lol. We really like Body Fortress super advance whey Protein in chocolate. Don't get the isolate one! It's God awful terrible and the reviews support that assessment. We mix it with milk and PB2 and serve in a super cold glass.....yummy stuff. It is in an orange and black jug at good ol' walmart for around $18. That should take are of your chocolate cravings. Keep in mind, I'm not sure what you are not allowed to have during this pre-op diet, but I'm assuming protein shakes are permitted.

Looks like we may be on the same timeline! Have you done the endoscopy/cardiology or don't you need to either?

I called, they said it's still being put into the system and they have 30 days, unless your office submits it as urgent, ughhhSent from my XT1254 using the BariatricPal App Oh crap. That really, really sucks. I feel for you. I'm a very anxious person by nature and a total worry wart. And our cases, being revisions, are a bit more complex and expensive which i am sure bcbs isn't quick to approve. It may be a longer wait for me too and not so fast like my husband's.

Me too, my last dr supervised and NUT appts are on Thursday. Already did psyche. And that is all my surgeon checked as far as my testing goes. I already had an old sleep study done so supposedly i won't have to re-do that. Surgeon did not mark endoscopy or cardiology appt. Boy am I gonna be PISSED if he changes his mind. I should be ready to submit on Friday according to his initial surgery requirements sheet. My husband, on the other hand, had to do all the aforementioned appts/tests and I can only assume it is because he is 9 years older than i. His surgery was approved in 1 day by BCBS fed and is scheduled may 2 for surgery. Keeping fingers and toes crossed for both of us!

Call BCBS this morning! They may have a decision.