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Frustrated with insurance denial

I called my surgeon’s office today because he submitted for a VSG to RYGB and was told it was denied because they want me to do 6months of supervised weight loss. I just had my VSG in December 2019! plus, their reason isn’t even listed under the revision surgery section in the handbook.

Since then I’ve developed a new hiatal hernia, GERD to my mid esophagus and esophagitis.

Of course I’ll file an appeal but I’m just frustrated. I’m sick of only getting 4-5hrs of sleep a night because the chest pain from the GERD is so bad it wakes me up. Im sick of taking the max allowed PPIs on top of 8-12 tums a day, and Thorazine for the hiccups causes by the GERD. I sent my surgeon a message asking for another prescription because I can’t take it anymore.

I'm jus so frustrated. I just don’t want to be in pain anymore.

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The surgeon should stress how serious it is that you need the revision

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1 hour ago, MIKEYY84 said:

The surgeon should stress how serious it is that you need the revision

His words to me were “you need a revision to get rid of the GERD. I’m sending over a request for insurance approval.” This was July 1st. He wanted to have me in for revision before August. My surgeon is definitely a non-nonsense kind of person so I’m positive that he’ll be sending over an appeal as well.

  • 1 month later...

Im curious what the outcome was for this

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