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Great news everyone my surgery was approved! Two appeals through my insurance company, but letters from my therapist, primary care physician and my bariatric surgeon all worked. I too wrote a really thoughtful letter. I was denied twice because my surgeon and I could not make the case for the band-to-bypass revision surgery but... finally the insurance company re-examined all the letters and the evidence and came to a decision that it's actually medically necessary. Wahoo!! Just found out today the surgery is scheduled for January 21, 2013!!! Wahoo