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Felecia

LAP-BAND Patients
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Everything posted by Felecia

  1. It sounds like you have a really good argument if nothing else :smile: You just have to be willing to Fight! Fight!Fight! Just expect the insurance company to deny first round. And do documentation along the way, MY INSURANCE COMPANY I had spoken with three different people who read the bariatric section over with me and all agreed that it should be covered and when it was submitted for approval was denied. I think it may have helped the appeal that I had all there names and dates that I had spoke with people at their company. Good luck
  2. I had to appeal my insurance denial twice before they agreed to cover the Sleeve. My insurance company agreed to cover the RNY or the band and based there denial on the Sleeve still bieg an "investigational procedure" so I looked up clinical trials and printed off about 25 still in progress on the band and RNY also I stated my reasons for choosing the Sleeve for long term health, I argued the expense of malabsoption issues that can come with the RNY or future intestinal blockage issues. I think you saved them money long term but these insurance companies don't make it easy. I also filed a complaint with the insurance commisioner in my state and in my appeal letter let the insurance company know that... maybe that helped But I think what really sent them over to approval was I had my surgeon (after much begging) call and speak with there "expert DR." who was in charge of the appeals at the board level. Hope this mess gets figured out for you.
  3. So glad to have this resource of knowledge from all of you! I have been lurking on this site up until now. I had surgery surgery 12-22 and for the first 48 hours really was questioning my decision, They had some trouble waking me up and getting me out of the recovery room and once in th hospital room I had horrible nasuea and dry heavs for the next 18 hours, so painfull. That has all subsided and now I am just dealing pain in my back on the left but right sided pain where my biggest scar will be. More than happy to be on this side of surgery and closer to recovery!

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