ANY ONE KNOWS A GREAT PLASTIC SURGEON OFFICE IN ATLANTA

Dr Bernadette Wang Ashraf johnscreekplasticsurgery.com

Kay, I have UHC as well and I was approved, but I had to fight for approval. My doctor, Marisa Lawrence sent in a pre-determination and it was denied. I appealed that and it was denied again. I was told if I wanted to appeal any further I needed to appeal through my employer because my plan is a self-funded plan. I did and I won! If they denied me my next step was to appeal thru ERISA.  It took me a 11 months to win approval, but it was well worth it.  I say all that to say be prepred for a fight! You will get one. They (insurance companies don't like to pay for this type of surgery. They love to say it's cosmetic in nature WRONG] it's reconstructive! Ginger's method is an option too, however it wouldn't have worked for me because my plan is a self-funded plan. It just depends on what kind of plan you have. By the way Ginger if you're reading this you look fabulous! Your post is what inspired me to seek the services of Dr. Marisa Lawrence. I have been approved for a complete Lower Body Lift whi*****ludes Adominoplasty [15847], Panniculectomy [15830], Hip Lift [15834-50], Lateral & Medial Thigh Lift  longitudinal with groin [15832-50 & 15832-50-22], Buttock Lift [15835-50]  Bracioplasy-longitudinal [15836-50-22] and Direct excision of the Axilla (the turkey neck that is hanging from underneath my arm) LOL [15839] .  My surgery will be in two stages my LBL will be done first (scheduled for May 5th and my arms will be done 6-8 weeks after that. Keep your head up Kay and keep fighting! If I can answer any questions email me. Patricia

Hi Patricia, I have great news i just got off the  phone with UHC I was told I was approve thru Dr. Marissa Lawrence I'm giving them  a call tomorow to confirm. I'm excited.  My insurance said date of service they have me for is April 30, 2008. Wow !!!Patricia we are on our way. Thank you Ginger for recomending me to her.  Kay.

Hi All,

 

 

Yesterday I posted I was approve after calling the Dr office and calling UHC I was told I was misinformed, what they got was notification of service on file, nothing has been determined yet. These folks are crazy lol!!! I might have to put up a fight after all. I guess I’ll  await my verdict. Kay!!!! Then I’ll proceed for the fight of my life with UHC if have too. Kay.

 

 

Kay, Don't be discouraged. Keep fighting! UHC is crazy, it's like the right hand don't know what the left hand is doing! You will get one person that tells you one thing when you call and the next time you talk to someone else they can't find any record. What I found out is that only certain departments can see certain screens. Anyway, it's crazy! Be prepared to appeal. I would start drafting an appeal letter now just in case you need it. My philosophy is to hope for the best, but be prepared for the worst.  I look forward to your posting saying you are approved! Did your insurance require Dr. Lawrence send in a pre-determination? Is your plan self-funded or the traditional? Is there a exclusionary clause for this type of surgery?  At any rate, DO NOT just give up! Keep fighting! Fight it till the end! If you don't fight for yourself noone esle is going to. It just ridiculous how hard we have to fight for something that is medically necessary! thinking about trying to get a mastopexy approval since I have grade 3 ptosis, but I don't want to press my luck. Maybe I will, the only thing they can say is no. It can't hurt, huh?  Patricia

Hi Pat,

 

Your so right about UCH each time I called I get a different answered they are nuts!!!  I was told DR. Lawrence needed to send in the pre-determination, right now I’m being told they there’s just an authorization given on the notification they received for the planned surgery. Is still being reviewed, so I’m thinking right there’s no exclusion or else they would not have requested additional information such place of surgery and date, from the DR office  so I think with UHC there’s no telling I will fight them to the end even I have to go to my HR department.   Thanks Patricia for your advice right now I’m preparing  and drafting all my documents one of request was for the mastopexy too I desperately needed and tummy tuck,  I was hoping to get those two approve and my next procedure will be for my inner tights and arms.  I said go for it send it in what the worst they can say no if so appeal it like you have the others lol!!! Kay.

 

Hello all, UHC denied me stating the reason was cosmetic that I can have the DR office send in an appeal to why is not.  Well the fight is on.

So UHC, they did the same thing to me! That's bullshiggidy! Don't you give up, keep fighting! My advice is you need to write it. I would not leave something so important to the doctor's office.  They could never write it from your point on view. It needs a personal touch.  Do you have the denial letter yet? If not, wait to recieve that so you can include with your appeal along with the doctor's pre-determination. Also follow all the guidelines on the letter.  By they way I did recieve your message, but lost it and didn't know how to retrieve it again. Email me and I can give you some pointers [email protected].

OH Thank you I will email you I need some pointer.  kAY.

Hi Kay -- I had a breast reduction and tummy tuck in 2003.  My surgeon was fantastic.  His name is Joseph M. Woods IV, and he has an office in the DeKalb Medical Center complex as well as one on Collier Road.  I highly recommend him!  Good luck.  dec721