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Band to Sleeve Revision Struggle with Insurance Approval
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I had a successful lapband placed in 2012- I'm 5 foot 3 - I went from 230 to 145 lbs. I even went thru a pregnancy and only gained 15-20 lbs or so and instantly lost that after I had my baby. I loved my lapband. I only had about one or two fills. I wasn't a fan of the port but I lived with it. I never had any problems. About 10 months after I had my child I started having acid reflux problems and went into see the doctor oct 2016. He checked my band and stated that it needed to be removed immediately he thought it was eroded and wasn't sure.. So he removed it. We talked about revision to the sleeve. We removed it the next day. There was no erosion but there was some slippage. Then he told me to the heal and go thru the holidays and we would start the process of the revision process. So come Feb I went back in and we started the entire process with the test and insurance mess I have been thru all the appeals the peer to peer I have finally hired the lindstrom attorney. I am on my final appeal. I am sooo frustrated insurance keeps denying me (BCBSofNC) stating that I do not have the BMI. When clearly in my insurance it does not state that you have to have a high bmi for a REVISION!!! I mean I am not going to be over weight when I just had a successful Lapband REMOVED!!! Which clearly now I am back up to 200lbs ! and the attorneys are fighting that.
Has anyone else had this problem? Why is insurance so stupid? They are seriously going against their own writing word they wrote. I wish I could have gone back to that day at the doctors office and asked more questions and also let them unfill and just see how it was instead of acted so quick. but the doctor made it sound so serious and I was so emotional to lose a tool that work and made my life so great!
Now I have gained weight and depressed about it. and it has been a year and battling this stupid insurance company that can't get it thru their head - about a BMI for a revision after a lapband removal...