I’ve been approved for a revision

[Glorious Release 35]

It’s been a while but I’m back. I have been suffering from GERD and Regain. Insurance fought me all the way but I was finally aloe for revision. Meeting with my Surgeon next month, hopefully to set date.

[Hop_Scotch 1,627]

That's great news for you and well done on fighting for your rights on this!

[Glorious Release 35]

Thank you. Trying to figure out this app tonight. So much has changed in 7 years. Lol

[GradyCat 3,692]

So can I ask a question? What are the insurance criteria for revisions? You're under 40 GMI now, but you have GERD, so is that a comorbidity? Are the approval requirements for a revision different than for original surgery?

[catwoman7 10,879]

1 hour ago, GradyCat said:

So can I ask a question? What are the insurance criteria for revisions? You're under 40 GMI now, but you have GERD, so is that a comorbidity? Are the approval requirements for a revision different than for original surgery?

I know you didn't ask me this, but some insurance companies will approve revisions if there's a medical reason for them. So GERD would count...

[California Guy 131]

A hernia or acid reflux could be qualifying conditions.

[lynmcg 9]

I just had my revision on 12/14 because of acid reflux. Good for you for fighting to have your revision done. Best of luck.

[Glorious Release 35]

Thanks everyone. Insurance criteria varies by providers. Most want it to be “medically” necessary. Surgery failure, weight gain, complications etc. I used a medical advocate to gain approval.

[catwoman7 10,879]

8 hours ago, Glorious Release said:

Thanks everyone. Insurance criteria varies by providers. Most want it to be “medically” necessary. Surgery failure, weight gain, complications etc. I used a medical advocate to gain approval.

if any approve it for weight regain, I'd think they're few and far between. I haven't heard of that, but you may be right. I know some will approve it for medical reasons, though - like GERD or other complications that can't be "fixed" through more conventional means. And many won't cover revisions AT ALL (like mine...luckily, I haven't needed one). I have a friend who's suffered horribly for the last couple of years from a 10-year-old lapband. It worked fine for a few years, but not anymore. Her insurance company won't budge. I feel horrible for her.

[YESSYISAWESOME 13]

OMG !! you are so lucky, i have kaiser insurance. I need a revision. I gained 40 lbs and have terrible Gerd. I am praying i get an authorization today for an appointment with my surgeon. I really hope my surgeon approves me to get a REVSION. I already got all the test needed, endoscopy a cat scan . Everything is in my chart showing i have bad Gerdd. Honestly i just need another shot to try and get this right. I really hope my surgeon approves me for revision. I don't want to gain all my weight back. That would be horrible

[Recidivist 1,141]

I notice that several of you mentioned GERD after bypass. I suffered from mild to moderate GERD before surgery, and one of the reasons I chose bypass over the sleeve was the fact that it (theoretically) eliminated GERD. Thankfully, I haven't had any problems since bypass surgery.

I'm curious to know whether your GERD came back gradually or was it a problem from the very beginning after bypass surgery? Did your doctors tell you why it was happening?

[catwoman7 10,879]

2 hours ago, Recidivist said:

I notice that several of you mentioned GERD after bypass. I suffered from mild to moderate GERD before surgery, and one of the reasons I chose bypass over the sleeve was the fact that it (theoretically) eliminated GERD. Thankfully, I haven't had any problems since bypass surgery.

I'm curious to know whether your GERD came back gradually or was it a problem from the very beginning after bypass surgery? Did your doctors tell you why it was happening?

mine completely went away for the first two or three years. It gradually came back, but it's not as bad as it was pre-surgery. A couple of over-the-counter antacids will usually take care of it. I did mention it to my surgeon during one of my follow-ups. He sort of shrugged and said "bummer". So evidently it sometimes does come back - although I'm not sure how common that is.

[mae7365 372]

I had GERD, Gastritis, Esophagitis and Hiatal Hernia. All GI issues had to be diagnosed by a gastroenterologist. I had an endoscopy with Bravo (pH testing), esophageal manometry, and barium swallow tests completed before Aetna approved my surgery. I had weight gain, but wasn't in the Obese range, so that didn't factor in.

[YESSYISAWESOME 13]

hi there question, so you had the sleeve, then they did the REVISION to the BYPASS?

[Elizabeth Smith 3]

Hi, can you explain to me what GERD is please. I am losing so much weight I do not know what to do.... I have been in hospital two more times after my first procedure. I have had the gall bladder removed and had malnutrition. Has anyone else had these complications please