Paying for Consults??

I have an Open Access HMO (which is a no referral type policy).

I did my research and knew that my Insurance would cover a panniculectomy if it was deamed "medically necessary" (rashes and length on Panni). So the PS just had to use the right billing code for the medically necessary procedure vs the billing code for a cosmetic one - just like any other medical appointment.

It took some convincing to get the PS to agree to bill it and I had to sign something that said I agreed that if the Ins company refused to pay for the consult, they I would still be responsible for the full consultation fee. Seemed a little excessive to me - but I guess they have gotten screwed on it before.

Best thing is to find out if your Ins even covers it, and then call and ask about the consults and if they will cover them as co-pays.

Best of luck!!

Oh, and while it isn't common for Ins to cover the panniculectomy, it is VERY rare for them to cover anything else...