Insurance approved band removal but denied revision to sleeve

[kgarrettsatx 109]

At first i was upset cuz now i have to pay $14,500 for the sleeve revision in the same surgery. Shouldnt there be somewhat of a discount since im already under anesthesia and ins is covering that? Anyway. Trying to see it as glass half full. Paying will give me more of an incentive to follow the rules and be successful since im investing hard earned money. Potential July 18th surgery date!!!!!!

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[MissKay 329]

Wow, that's like 4 times the amount I paid just for my sleeve surgery. But I used the BariatricPal Mexico team, so that's why. In the US I was looking at about 10k for mine, and there was no way I could have self-paid that.

Good luck!

[kgarrettsatx 109]

Thanks girl. Hate to pay it but a healthier me is a good investment

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[BeagleLover 1,020]

IF there is one, what is the insurance appeal process? I would keep at that and bump it up until the decision is not made by the insurance folks. There are 3rd parties that specialize in these appeals. I can't remember his name off the top of my head that successfully overturned a denial, but I suggest you search on this site.

[kgarrettsatx 109]

IF there is one, what is the insurance appeal process? I would keep at that and bump it up until the decision is not made by the insurance folks. There are 3rd parties that specialize in these appeals. I can't remember his name off the top of my head that successfully overturned a denial, but I suggest you search on this site.

Thanks @beagleLover. The only problem is i need the band out asap. My esophagus has class c erosion and im vomiting blood every time i try to eat or drink. Unless an appeal can be streamlined within a week or two.

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[Daenerys Targaryen 109]

You are not alone. My revision surgery was scheduled for June 28th. Insurance approved band removal and denied bypass. Now I am starting the appeals process. Hang in there and good luck!

[BeagleLover 1,020]

I find it hard to believe they won't pay for it under these circumstances! That's CRAAAAZY!

Again, I don't know your insurance. Call them to find out their process.

Do you have a Bariatric Center of Excellence hospital near enough to where you live? If so, what would it cost there?

[Stephy5 33]

IF there is one, what is the insurance appeal process? I would keep at that and bump it up until the decision is not made by the insurance folks. There are 3rd parties that specialize in these appeals. I can't remember his name off the top of my head that successfully overturned a denial, but I suggest you search on this site.

Thanks @beagleLover. The only problem is i need the band out asap. My esophagus has class c erosion and im vomiting blood every time i try to eat or drink. Unless an appeal can be streamlined within a week or two.

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With the Class C erosion will they do your conversion the same day?

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[kgarrettsatx 109]

Yeah he said he could do it at the same time. I was so relieved. Finally have surgery date of july 26. Sooooo ready!!!!

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[BeagleLover 1,020]

I notice this is later than your prior date. Were you able to negotiate a lower cost?

[kgarrettsatx 109]

I notice this is later than your prior date. Were you able to negotiate a lower cost?

I know. I cried for two days but finally accepted that its not in my control and ill suck it up. The dr office is negotiating a lower rate for anesthesia and facility so its looking better than full price!!!

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