I knew it was coming but I can't help but feel upset. I am a revision candidate from the band to sleeve. They have approved my band to come out. That is a prayer answered in itself. I have had pain and complications for almost 5 years and 2 insurances have denied taking it out. I will be doing that in June. The letter said I have to have a Nut and Psych appt. which is normal. But the letter said that I need to PROVE that I followed my diet and exercise program after my first surgery. Which part? While the band was working I lost 32 pounds. A few month after surgery I had complications and got to where I couldn't eat at all so obviously I gained weight in starvation mode. That requirement is really open for them to say anything. I am a little scared now that this is not going to work out.... Sorry to be so negative, I'm usually so positive. But I am so fed up with these insurance companies not treating me as an individual case instead of the herd. I think I need a pep talk... On the bright side I've got the psych appt Friday and the nut appt next Tues so they can submit again next week with those and whatever the docs office decides will prove that I was compliant after my first surgery... Meanwhile I'll try not to freak out :o/

Oh no! I am do sorry. I had that problem with Cigna. Hang in there! Maybe the appeal will be quick.

Thanks for the encouragement!!

same exact thing happened to me today w atena they said they had no proof of my high blood pressure high colestrasl which was all stated in my clinicals

Did you get approved and sleeved or are you still waiting too?

What do they need? Flashing neon signs? That is crazy and I am sorry to hear that

I know right?! It is so crazy and ridiculous!!

Forgot to mention I passed psych he will recommend surgery! On to nutrition tomorrow. Also got records of my two bulged discs in my back to send with the resubmit. Good night and my prayers at with the families in Oklahoma tonight. Too much tragedy lately

Forgot to mention I passed psych he will recommend surgery! On to nutrition tomorrow. Also got records of my two bulged discs in my back to send with the resubmit. Good night and my prayers at with the families in Oklahoma tonight. Too much tragedy lately

Congrats on the psych eval!

Thanks! Nutrition went well today despite being soaked trying to get there lol.

Oh no! I am do sorry. I had that problem with Cigna. Hang in there! Maybe the appeal will be quick.

GUESS WHAT?! I got a call from my insurance case worker at 5:45pm ET, and I GOT APPROVED!! Only one day into my appeal!!! My Dr office was already closed so I emailed them, asking for a date so I can make plans etc. The caseworker is going to fax an approval to them, then mail the official letter to both of us. Thanks again for your prayers, they worked!!! And so did all the advice I have found on this website. :-D

That is amazing!!! I am so happy for you!

Yay congrats!!

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I had kind of a rocky day. I called to schedule my removal and the earliest they could get me in is 6/25 and the doc wants removal at least one week before sleeve. Well my plan changes on 07/01 and the scheduler could not work with me I emailed my insurance coordinator and told her she did not have to submit to BCBS for approval bc I wasn't going to get scheduled even if it was approved. She emailed me back saying she had already submitted but she has a plan... IF I get approval, she will ask the doc to do the two all in one on 06/25. He will prob want an endoscopy and to meet with me again for him to decide so IF all of hat comes together I will be sleeved on 6/25. If not I will have to wait and submit to the new plan. Btw my HR still doesn't know what insurance/plan they are going with Staying positive though bc I get to evict my band forever on 6/25

DON'T GIVE UP ON BLUE ! I HAVE ONLY HAD BCBS FEP 4 MONTHS AND ALLREADY HAD BAND TO SLEEVE REVISION - HERE'S THE STORY: BANDED IN FEB 2010 WHILE WITH ***. THEY PAID 5K I PD 11k. DID OK UNTIL THE FIRST FILL. THEN THE VOMITING STARTED. TOOK THE FILL OUT, NEXT VISIT PUT IT IN. THIS WAS THE SCENERIO FOR PROBALY 18 MONTHS. SOMETIMES I WOULD GO SEVERAL MONTHS WITH NO FILL HOPING TO LET ANY "SWELLING" GO DOWN. WEIGHT LOSS DWINDLED TO 2-4 POUNDS A MONTH THEN NOTHING. BUT I REALLY DIDN'T PUT ANY ON EITHER. JUST STAYED WITH APPROX 36 # LOSS ALL THAT TIME. DURING THIS TIME I ALSO STARTED HAVE WIERED CHEST PAIN, FIRST THEY SAID MY ELECTROLYTES WER OFF- WELL DAH IM NOT EATING 'CUSS I LOSE IT ALL! THEN THEY SAID I HAD UPPER CHEST WALL INFLAMMATION - DAH COULD IT BE THE BAND? OH NO ! I HAD NOT ONE BUT 3 UPPER GI'S- ALL NORMAL. FINALLY I SAID WHAT CAN I DO TO TAKE IT OUT AND GET A REVISION? WELL I HAD TO CHANGE FROM THE *** . SO DURING OPEN ENROLLMENT I SELECTED BLUE -AS MY SURGEON'S OFFICE SAID THEY HAD GOOD REPONSE TO REVISIONS ESPECIALLY SINCE I HAD REMAINED IN THERE CARE AND WAS WELL DOCUMENTED. THE NEW PALN DID REQUIRE A NEW PCP, LABS, PSYCH, CARDIO EVAL DUE TO THE ANESTHESILOGIST CONCERENS. BUT FORM THE TIME THE NEW INSURANCE WENT INTO EFFECT IN JANURY, I HAD SURGERY APRIL 30 TH. ALL THE CHEST PAIN WAS GONE THE NEXT MORINING! I WAS UP AT 6:00 AM AND WALKING- THEY COULD NOT HOLD ME DOWN. AFTER THE PAIN I HAD SURGERY WAS NOTHING AND I GUIT PAIN MEDS 3 DAYS LATER WITH BLUE YOU SHOULD HAVE A NURSE CASE MANAGER, TRY TO GET TO HER AND SEE WHAT DOCUMENTATION YOU MABE MISSING TO GET THIS THROUGH! USUALLY THAT IS THE PROBLEM- JUST KEEP PUSHING. HOPE TO HEAR BETTER NEWS FROM YOU SOON . GOOD LUCK! /// DIANA nVEGAS

That is amazing!!! I am so happy for you!

Thank you! and I just read your post and I am praying it all works out for you too!!!

same exact thing happened to me today w atena they said they had no proof of my high blood pressure high colestrasl which was all stated in my clinicals

Don't they even look at and read what is submitted??? Good luck!

DON'T GIVE UP ON BLUE ! I HAVE ONLY HAD BCBS FEP 4 MONTHS AND ALLREADY HAD BAND TO SLEEVE REVISION - HERE'S THE STORY: BANDED IN FEB 2010 WHILE WITH ***. THEY PAID 5K I PD 11k. DID OK UNTIL THE FIRST FILL. THEN THE VOMITING STARTED. TOOK THE FILL OUT, NEXT VISIT PUT IT IN. THIS WAS THE SCENERIO FOR PROBALY 18 MONTHS. SOMETIMES I WOULD GO SEVERAL MONTHS WITH NO FILL HOPING TO LET ANY "SWELLING" GO DOWN. WEIGHT LOSS DWINDLED TO 2-4 POUNDS A MONTH THEN NOTHING. BUT I REALLY DIDN'T PUT ANY ON EITHER. JUST STAYED WITH APPROX 36 # LOSS ALL THAT TIME. DURING THIS TIME I ALSO STARTED HAVE WIERED CHEST PAIN, FIRST THEY SAID MY ELECTROLYTES WER OFF- WELL DAH IM NOT EATING 'CUSS I LOSE IT ALL! THEN THEY SAID I HAD UPPER CHEST WALL INFLAMMATION - DAH COULD IT BE THE BAND? OH NO ! I HAD NOT ONE BUT 3 UPPER GI'S- ALL NORMAL. FINALLY I SAID WHAT CAN I DO TO TAKE IT OUT AND GET A REVISION? WELL I HAD TO CHANGE FROM THE *** . SO DURING OPEN ENROLLMENT I SELECTED BLUE -AS MY SURGEON'S OFFICE SAID THEY HAD GOOD REPONSE TO REVISIONS ESPECIALLY SINCE I HAD REMAINED IN THERE CARE AND WAS WELL DOCUMENTED. THE NEW PALN DID REQUIRE A NEW PCP, LABS, PSYCH, CARDIO EVAL DUE TO THE ANESTHESILOGIST CONCERENS. BUT FORM THE TIME THE NEW INSURANCE WENT INTO EFFECT IN JANURY, I HAD SURGERY APRIL 30 TH. ALL THE CHEST PAIN WAS GONE THE NEXT MORINING! I WAS UP AT 6:00 AM AND WALKING- THEY COULD NOT HOLD ME DOWN. AFTER THE PAIN I HAD SURGERY WAS NOTHING AND I GUIT PAIN MEDS 3 DAYS LATER WITH BLUE YOU SHOULD HAVE A NURSE CASE MANAGER, TRY TO GET TO HER AND SEE WHAT DOCUMENTATION YOU MABE MISSING TO GET THIS THROUGH! USUALLY THAT IS THE PROBLEM- JUST KEEP PUSHING. HOPE TO HEAR BETTER NEWS FROM YOU SOON . GOOD LUCK! /// DIANA nVEGAS

Thanks for the encouragement! Unfortunately my employer is the one changing the plan. They say they can't afford it any more. I hope they just pick another plan with BCBS but there is no guarantee they will. I'm just along for the ride at this point. I've done everything the insurance asked. It is on them now to approve or not. Then if approved it is on the doc to decide if he will do all in one. Whatever happens is supposed to happen. 3 years ago I was ready to get the gastric bypass and that didn't work out. Now there is another option that is better for me! The sleeve if BCBS doesn't approve or the doc doesn't feel comfortable with doing it all in one, then maybe I am supposed to wait again for some reason. Just gonna hang in here and wait till they all decide lol

Thank you! and I just read your post and I am praying it all works out for you too!!!

Thanks as always for the support. I am looking forward to seeing your journey. Next up for you: a surgery date!!