Insurance & Skin removal
I had Empire Blue Cross and they paid for my panni removal and I didn't have any rashes. You really should contact your insurance company to find out what their qualifications are to cover that surgery. Also, they may deny you the first time you submit the clain or request. Don't just take that as the final answer but appeal it. My insurance denied me the first time and I sent in an appeal and it was then covered.
Sonya
Sonya
I was about 14 months post RNY so I had lost all my weight, had been stable for months and had a normal body fat %. According to my PS office my insurance co didn't do pre-approvals so they did the surgery and then submitted the request. However they did suggest that I contact them to find out if there was a pre-approval process. I was told no, go ahead w/ the srgery and then submit and they never said any of their requirements for covering the panni removal.
Turns out you had to be 18 months post op, documented rashes, stable weight for 6 months so since I didn't meet any of those I was denied. I wrote an appeal letter sating why it was medically necessary I was approved. I also think that having called in prior to the surgery and was not told any of their requirements helped. Just shows, don't give up or take no for an answer.
Yes, my insurance paid for my RNY, took them less than 3 days to call w/ my approval.
Turns out you had to be 18 months post op, documented rashes, stable weight for 6 months so since I didn't meet any of those I was denied. I wrote an appeal letter sating why it was medically necessary I was approved. I also think that having called in prior to the surgery and was not told any of their requirements helped. Just shows, don't give up or take no for an answer.
Yes, my insurance paid for my RNY, took them less than 3 days to call w/ my approval.
I am trying to have a panni removal done with a belly button hernia repair.
Medicare and Blue Cross/ Blue Shield paid for my band 4 years ago.
I have the panni hanging low enough to qualify.
They called and said I only have one note for a rash and the doc got me some creame.
It is not enough documentation. Monday I go back to my PCP to show him the rash is back and it is real bad.
When he lets them know I still have a rash, do you think that will be enough?
Thank you, Pat
bajwa@wild blue.net
Medicare and Blue Cross/ Blue Shield paid for my band 4 years ago.
I have the panni hanging low enough to qualify.
They called and said I only have one note for a rash and the doc got me some creame.
It is not enough documentation. Monday I go back to my PCP to show him the rash is back and it is real bad.
When he lets them know I still have a rash, do you think that will be enough?
Thank you, Pat
bajwa@wild blue.net
Eveningblossom
It depends on your insurance. For my insurance you had to show 3 months (or maybe it was 6 months...? it's been a couple of years so I'm not sure) of unsuccessful attempts to eliminate the rashes with multiple treatments. Just trying one product was not enough.
Lora
Lora
14 years out; 190 pounds lost, 165 pound loss maintained
You don't drown by falling in the water. You drown by staying there.
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