Question:
Has anyone been approved for a TT thru BCBS?

Hi. My PS Sent off a letter with pics back in october. BCBS has since been saying it's in 'review'. Finally I was able to get the number to the review company and they say they have nothing in their system. So yeah the infamous ol "we don't have it, resend it" routine. My question, has anyone been approved for a TT thru BCBS? Is it hard? I had to jump through less hoops to get them to approve my gastric bypass. That was a piece of cake compared to this. - Renee    — Renee V. (posted on January 8, 2003)

January 8, 2003
Hi, My friend has bc/bs of florida and she was denied. Don't ask for a TT, ask for a panni. However, I do know of people getting approved for it. It is all on a "individual" case. My friend is planning on sueing them. I don't know how that's gonna work out. But don't give up, resend it to them, even if you have to send it to them 10 times.
   — Luscious1 X.

January 8, 2003
I got mine approved by BCBS/NC... But had to go to level two appeal. NOTE: with BCBS you DO NOT have to do the level one appeal to get a level two.... so save yourself TIME (it was a waste... they had a urologist and a LPN review my request)... Tell them you want a level two....
   — star .

January 8, 2003
My advice is to appeal, so that you can have both surgeries done at one time, with one general anesthesia. My tummy tuck and armlift were approved by my secondary insurance, no questions asked. However, the primary provider denied, forcing me into their appeals process. I think that pictures (embarrassing as they may be) are an absolute necessity. My appeals packet included a copy of the plastic surgeon's original letter of medical necessity and his pictures...letters of medical support from my PCP and bariatric surgeon....my own personal letter outlining in detail all the reasons that this surgery was physically and emotionally important to me....and finally, I submitted a copy of the 1996 Position Paper from the American Society of Plastic Surgery, entitled :"Treatment of Skin Redundancy Following Massive Weight Loss". My primary provider approved my surgery within one week of receiving the appeals packet. The paper can be obtained from www.plasticsurgery.org/profinfo/pospap/skin.htm. Good luck!
   — Diana T.

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