Question:
Special plans unit for Alaska, disallowed as above usual and customary

I had a double tummy tuck 1 year ago. AETNA preapproved and pre certified. Paid all except $4 grand in surgeons fees. Disallowed as above the usual and customary. What crud! After fighting for a full year, I find out that there is no "code" for a double muscle tuck and skin removal. How do I proceed from here? Any suggestions? All are appreciated.    — Christine N. (posted on July 15, 1999)

July 15, 1999
Did they pay the surgeon anything? Sometimes the surgeon will accept what the insurance company pays, and/or make arrangements for payment of the balance. At the VERY least the insurance company should've paid what the allowable fee for a single muscle tuck and skin removal. And if so ... I should think your surgeon would work something out with you. Just curious, since you and I parallel so much on other things, why was the "double tuck" necessary? I would appeal the decision to your insurance company and/or State Insurance Commissioners office, and if that doesn't work, I'd then look up the obesity law attorney that is on this board .. cannot think of his name though ... I've seen posts about him though.
   — Sherrie G.