Question:
Aetna USHC - Ventral Hernia Approved-Abdominoplasty Denied -- Any Suggestions?

My plastic surgeon is not experienced with getting total approvals after RNY --- I knew that but he was the only doctor even willing to try to get me approved.... Well AetnaUSHC approved the hernia repair but denied the abdominoplasty.... They said the pictures showed that the pannus does not hang over the pubis...... it doesnt but I have horrible saggy skin which will keep pulling on the hernia area.... My PCP had sent in a letter that briefly stated I had rashes and back pain, RNY surgeon did the same thing ... I want to appeal it and would like any help or information from people who had this situation... Do I take pictures of rashes.... maybe pictures of all the excess skin other than standing straight up ? like showing that it is handfuls? ---- Im desperate and I dont have the $4,000 like the surgeon suggested I pull out of the air to have the abdominoplasty.... Thanks    — darcieleigh (posted on December 19, 2001)


December 19, 2001
Do I take pictures of rashes.... Maybe pictures of all the excess skin other than standing straight up ? ********Yessssssss to all the above.. Take a look at my appeal letter at... http://www.angelfire.com/journal2/surgery Also take lots of pics. Especially of the infection under the panni.. also lean forward show pics.. any angle you can get to show the exact extent of the panni.
   — Victoria B.




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