Denied for Abdominoplasty

Has any one been denied then appealed and won? They said I should write I letter stateing why they should pay for it if you have any input as to what I should write please let me know. Denice

Who is your insurance carrier Denice?

Tina I have bcbs of De Denice

I also have BCBS DE but I have the PPO. Do you have the same? I haven't had my surgery yet but once I do and after I've reached my goal I'm probably going to want a TT so I'm very interested in the reason BC gave for their denial. Please let us know. Thanks, Dee

Dee I also have the PPO and the reason they gave was this procedure does not meet the policy guidelines for medical necessity. I am going to appealthe decision and see what happens. Denice

Do you have a list of things that would make this procedure medically necessary? I know that to have the RNY you have to have 3 of the obesity related medical conditions on their list for them to cover it. Do they have a similar list for the TT? Thanks Dee