Thank you all.

[jellybeangyrl]

Hello, my name is Nancy I have been lurking on this forum for a couple of weeks, and decided to join. Your comments have been a big help to me. I got the lap band done back 12 years ago in Mexico. I live in Pennsylvania, have been having trouble with the lab band since my twin pregnancy 4 years ago. My insurance is BCBS of Alabama. I am being denied removal - I don't even want anything else done, just the band taken out. Not medically necessary was the reason for the denial, they also denied the first appeal from the Doctor. I am tired of their games already, and asked for a third party review. I had a barium swallow done and x-rays and sent the disc with the appeal, it shows the dilated esophagus quite clearly. I have port pain, constant vomiting, but sometimes I am able to eat normally, and sometimes I vomit on just water, not being able to keep anything down first thing in the morning, and vomiting sometimes in my sleep. The port has never been filled. I was told it was upside-down when I first tried to get it filled -now it's lodged sideways. It helped me to know that I am not alone in this struggle, and all your suggestions to others have helped me make my case.

 

[Munchkin]

Seems to me if it isn't in the right place/position and it's causing you problems, you can present a case to get it removed. The first thing you need is a real copy of your insurance EOC. Usually about a 100 page document. Once you have it, read it. Learn your coverage and the appeal process.

 

[k9ophile]

No specific advice just:

 

[jellybeangyrl]

Seems to me if it isn't in the right place/position and it's causing you problems, you can present a case to get it removed. The first thing you need is a real copy of your insurance EOC. Usually about a 100 page document. Once you have it, read it. Learn your coverage and the appeal process.

I have perused that thing carefully! Thank you!

 

[Munchkin]

I have perused that thing carefully! Thank you!

Next, you need to talk to @Larra and @DianaCox

 

[southernlady]

Welcome @jellybeangyrl

 

[jellybeangyrl]

OK, what are my options if they deny me again. I've heard of someone doing an ER visit and having it removed? Anyone with some insight on this would be helpful.

 

[Charris]

Welcome! I would suggest start by talking to Lara and Diana. Don't get frustrated and do something that is going to cause you more suffering/grief than relief in the future!

 

[jellybeangyrl]

I have been approved. Thank you all.

 

[Larra]

So glad for you! Of course there should never have been any question about approval, but we can't undo that. Let us know when you have a date to get that miserable thing removed.

 

[writegirl]

Glad the review went in your favor. Hope you're feeling better quickly!

 

[DianaCox]

YAY!