Jump to content
×
Are you looking for the BariatricPal Store? Go now!

What are the magic words you need to say to get approved for revision?



Recommended Posts

I agree with above. Perhaps I'm cynical, but I generally assume that the surgeons will be glad to operate on any willing patient as long as insurance (or the patient) will pay for it. Of course with all tests and precautions to avoid any malpractice claims etc. as well. I think it's all about what insurance requires, but your surgeon should be able to partner with you on that and advise you on the best way to approach.

Share this post


Link to post
Share on other sites

It seems to me like the surgeons want to get rid of the band so they are willing to do the conversion

Share this post


Link to post
Share on other sites

Sorry, docs won't operate on anyone. Just not true.

I'd be surprised if your insurance will fund your sleeve at a BMI under 40.

At a BMI of 35, most insurance companies require 3 comorbidities. I'd say your magic words to try if you're a 35 BMI are: arthritis, stress incontinence, high blood pressure, diabetes, pre-diabetic condition.

Here's a complete list:

http://www.nationalbariatriclink.org/comorbidities-insurancequalification.html

Share this post


Link to post
Share on other sites

First of all, anything is,possible...trust me. My story is very similar to yours although I really didn't have any issues with the band. My doc said that the band failed me, I did not fail the band! Lost about 100 lbs starting in 2007. It took many fills and tweeking to get me to my sweet spot. Found it and worked with it. In the summer my port started shifting so I went in for a port replacement and woke up with the entire band being removed due to erosion!!!! I was shocked, sad and feel like someone took the only thing that had ever worked for me in 30 years away just like that, snap!! I immediately began the revision proceed but with a BMI of 26, there was no way. I tried, I truly did to keep the weight off but at 50 lbs additional and 2 co mortalities I was approved for the sleeve. Had it done 1 week ago from tonight and it was the best thing ever. I have CIGNA and I had a tough time, but other people have had smooth sailing with CIGNA...I just can't figure them out. Make sure you find out if your ins will only cover 1 bariatric proceedure a lifetime. Sleeve is fantastic so far

Share this post


Link to post
Share on other sites

I assume this is directed at me... As you've written your response - yes of course that's not true. And you certainly don't have to be "sorry" for saying so. Just for the record what I said had many more caveats than what you've said below (the tests to rule out safety concerns and malpractice concerns represent many ways in which docs will rule out surgery for any individual).

My point was that it's more about insurance and established practices than the doctor's personal feeling is about the individual patient. EDIT - and that surgeons are financially motivated to help patients get approved for surgery.

Sorry, docs won't operate on anyone. Just not true.

Edited by thesuse2000

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

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 0 replies
      1. This update has no replies.
    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 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

    ×