Tummy Tuck
Hello there...don't post much but have a question...I am 5 years out today and when in May for a consult with Dr Lam...I rec'd a letter stating I was denied. I had letters from my doctor and obgyn photos and someone told me to appeal it...has this happend to anyone else???? How do you appeal, through the doctor on my own...any input wouldn help. Thanks!
Congratulations on your 5 year surgiversary!!! I assume Dr. Lam's office can help you with the appeal, but there is also a plastic surgery forum here where you might get some great suggestions and ideas.
http://www.obesityhelp.com/forums/plasticsurgery/a,messagebo ard/board_id,4861/
http://www.obesityhelp.com/forums/plasticsurgery/a,messagebo ard/board_id,4861/
Blessings, Jill
WLS 5/31/07. Maintaining a weight loss of 141 pounds and feeling amazing!
Happy Surgiversary to you,
I have not gotten to the point of needing plastics yet, because of a 45 pound regain.
I do remember early after my surgery, I went to the Barix Post-Op support group. A woman shared how she got her insurance to pay for the plastics. She appealed to the insurance company by mail, and was turned down. So, she took her photos to the insurance company, and met with someone, or more, showed the photos of all the rashes, and got her surgery paid for.
My suggestion would be to call your insurance company first to ask what their procedure for appeals is. Once you know that, then see if someone at Barix is knowledgeable enough to help you get moving on the appeal. I know that photos of skins rashes and doctors' visits is key.
Finally, document all communication with all involved, with dates, times and names. That will help you be able to know who helped you at different points along your journey.
I have not gotten to the point of needing plastics yet, because of a 45 pound regain.
I do remember early after my surgery, I went to the Barix Post-Op support group. A woman shared how she got her insurance to pay for the plastics. She appealed to the insurance company by mail, and was turned down. So, she took her photos to the insurance company, and met with someone, or more, showed the photos of all the rashes, and got her surgery paid for.
My suggestion would be to call your insurance company first to ask what their procedure for appeals is. Once you know that, then see if someone at Barix is knowledgeable enough to help you get moving on the appeal. I know that photos of skins rashes and doctors' visits is key.
Finally, document all communication with all involved, with dates, times and names. That will help you be able to know who helped you at different points along your journey.
Seek always to do some good, somewhere. Every man has to seek in his own way to realize his true worth. You must give some time to your fellow man. For remember, you don't live in a world all your own. Your brothers are here too.
Albert Schweitzer
Albert Schweitzer
R K.
on 6/24/12 8:59 am
on 6/24/12 8:59 am
From what I understand it has to be medically necessary. This usually requires more then a rash. Infections, etc and they must be well documented.
Good luck and congratulations.
Good luck and congratulations.
*
"If I only had three words of advice, they would be, Tell the Truth. If got three more words, I'd add, all the time."
— Randy Pausch
"If I only had three words of advice, they would be, Tell the Truth. If got three more words, I'd add, all the time."
— Randy Pausch
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