Jump to content
×
Are you looking for the BariatricPal Store? Go now!
$99 Yearly Supply Alert! 🌈 "1 per Day!" Bariatric Multivitamins

DENIED

lauriearnold

Recommended Posts

lauriearnold    40

lauriearnold
Posted

just found out today that my insurance denied my 2nd appeal. Am thinking very seriously at this point to quit fighting with insurance and going to Dr Alvarez in Mexico. My lap band has to come out due to a prolapse that will not fix itself. Been unfilled since December 2013 and very very cautious of what i am eating right not to avoid any emergency surgeries. Has anybody on here gone to dr alvaraz and have a prolapsed band removed and sleeve done at same time. Help i'm desperate right now.

ldatda@hotmail.com

arkansas

Share this post

Link to post
Share on other sites

BeagleLover    1,020

BeagleLover
Posted

I suggest you look at Walter Lindstrom's blog on WLS appeals:

http://wlsappeals.com/2094/walters_bariatric_surgery_blog/20-years-bariatric-surgery-patient/

Don't give up!

Share this post

Link to post
Share on other sites

paula4422    2

paula4422
Posted

Can I ask why you were denied? I guess I dont understand if it "has" to come out how can they tell you no?

Share this post

Link to post
Share on other sites

BeagleLover    1,020

BeagleLover
Posted

What is your insurance? What is their appeal procedure?

Share this post

Link to post
Share on other sites

lauriearnold    40

lauriearnold
Posted

UHC paid for the band removal and i got the bill today guys and the hospital bill alone was $34, 648 and dr fee was $4900 and i don't owe anything. matter of fact im in the positive still. UHC will only pay for one bariatric surgery per life time. So, I'm having to wait 3 months for stomach to heal cause i had 2 holes in my stomach from the band that had eroded into my stomach. the only thing that was not in my stomach was the buckle part, the whole band was inside my stomach. So, now i wait 3 months and i pay for the sleeve myself which i'm fine with as long as i know i am getting it and i know i won't gain any weight. I can't get back into the gym until january and it's hard right now to go in and train my clients even cause i can't show them proper technique due to not being able to lift more then 10 lbs so i've had to put all my clients off till january too. :(

Share this post

Link to post
Share on other sites

BeagleLover    1,020

BeagleLover
Posted

Wow. Are you going to have the sleeve surgery done in the U.S.?

Share this post

Link to post
Share on other sites

lauriearnold    40

lauriearnold
Posted

Yes, in the US. I have a friend who's cousin went to Mexico and she came back with an extra incision and didn't know what it was so my friend talked her into going to the dr. They did a cat scan on her and she was missing a kidney!!!!!!! NO, no mexico. I'd rather keep my organs and pay more in the US and i will have follow up care here where if i go to Mexico i will not. I will have to go to an ER to have a gastro look at me. I've already got the money saved up so i'm just waiting for my 3 month healing time and getting it done.

Share this post

Link to post
Share on other sites

AmyElizabeth01    6

AmyElizabeth01
Posted

My insurance wouldn't approve the lap band removal but did approve the sleeve. So I paid $600 for the band removal and insurance covered the rest. I'm so sorry you were denied. I still had to qualify, 40 bmi for last 5 years and all the other requirements.

Share this post

Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
Go To Topic Listing Gastric Sleeve Surgery Forums

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    Bariatric Forums

    For Patients

    Health Professionals

    Search Surgeons

    Bariatric Surgeons: Want to research a weight loss surgery surgeon? Enter their last name below to start!

    ×