From Denial to Appeal to Approval

[CharlotteWebb 275]

I had VSG 3/2015 after 2 small bowel obstructions, severe bleeding reflux, esophageal stricture my surgeon thought conversion to RNY would be best. My insurance denied the surgery. I wrote a fully detailed letter and they overturned the decision. I am approved and waiting for my surgery date. Super excited to be free from this bleeding narrowed esophagus and I am also getting the hernia next to my old repaired hernia fixed.

[FluffySaysForkIt! 823]

Wow! You have been through the ringer!

Glad you are getting the surgery you need now, best of luck to you.

[KCgirl061 1,531]

Sorry to hear you've had such bad complications. 😥 Hope you get your new surgery soon and that fixes things. Keep us up to date on the progress.

[CharlotteWebb 275]

I had great weight loss with the VSG I hit goal in roughly 7-8months and kept it off for almost 3 yrs but the complications started causomg lots of issues. My sleeve was stretched by a non bariatric hi doc because it and my distal esophagus were very narrowed with inflammation. I loat that restriction at that point. I couldnt live with that.

[New&Improved 1,780]

This is exactly why I chose RNY ! So many ppl end up revised to RNY anyways

[CharlotteWebb 275]

Sorry for my typing. I have fat thumbs. I really can spell, I promise.

[allies journey 144]

I am now in process of getting approved for the RYN due to the reflux disease that I have had for 30 years it's way worse than it was before the sleeve 2 plus years ago. Now taking 10 pills a day just for the reflux and the meds are not working properly at all. I'm either totally nauseous or vomiting all the time.
Having lots of tests to get data for insurance company to backup the doctor saying it is necessary for me to do this. I did sleeve surgery going by the surgeon advice and wasn't told that I had the option.
Anyway my sleeve surgery went fine but the hernia repair is now back as well.
Can you tell me how long it took to get approval??
Good luck to you.
Allie in SC

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[allies journey 144]

I had great weight loss with the VSG I hit goal in roughly 7-8months and kept it off for almost 3 yrs but the complications started causomg lots of issues. My sleeve was stretched by a non bariatric hi doc because it and my distal esophagus were very narrowed with inflammation. I loat that restriction at that point. I couldnt live with that.

I lost 87 lbs and went from size 24w to 12/14 ladies but never have reached my goal. Lots of other medical issues with other surgery so have not been able to exercise at all until recently. I just want to feel better.
Allie in SC

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[CharlotteWebb 275]

I lost 87 lbs and went from size 24w to 12/14 ladies but never have reached my goal. Lots of other medical issues with other surgery so have not been able to exercise at all until recently. I just want to feel better.
Allie in SC

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I got denied the first request for revision. My denial said, "You didnt follow your surgeons diet plan that's why we are denying your request for revision to rny."
I wrote them back a very detailed letter citing I didn't want to lose more weight. I imcluded that the complications are taking a serious toll on my health amd asked them to reconsider and they did then approved me.

They may deny you at first, appeal it. They aee doing their job trying to save their company money

[allies journey 144]

Thanks for responding to my post and I will definitely appeal if I get turned down. I have my surgeon and my gastrointestinal doctor fighting for my revision surgery so hopefully it will be resolved quickly. I hate being on so many meds for 1 problem and the meds are not working properly now so I'm desperate to find a solution. Thanks again.
Allie

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