Help with Plastics Letter to Insurance Company

KellBell
on 10/4/07 12:03 am - Lexington, SC

Need some help... My dr. submitted to ins. co. to have a tummy tuck.  They are wanting info on the rashes I have been having in the skin fold.  I have had several but never went to PCP to have it treated.  I used OTC antifungal medications. Help me with a "winning" letter to them.... Thanks, --Kelly

   KELLY  (309/171/150)

cmobley4
on 10/4/07 12:37 am - Clovis, CA
Hey Kelly,  Well your gonna have to start with outlining the approx dates of the rashes and your tx. then take pictures (front, side and below) views.  be as detailed as you can... even if its alittle gross, just dont over do it, after all.. RN's are reviewing these... and sometimes even MD's.  I helped a friend of mine, Pat, do the same thing... and the pictures sealed the deal for her.. .and I think she got her tummy and legs done! GOOD LUCK
Jennifer R.
on 10/4/07 4:48 am - Spartanburg, SC
my doctor wrote this kick azz letter to my insurance company, they let me read it but didnt want to give out copies.. but it said a bunch of doctor mumbo jumbo and pretty much that the extra skin hanging is causing impetigo yeast infections that have to be treated with different types of ointments and creams and daily preventative powders and or creams. i think what sealed the deal was the vaginal yeast infections.. i didnt have any other documentation to go along with his letter except for pictures of me naked that he took in his office. he also noted that my skin hung down over my umbilicus causing rashes there too.. so his main wording was to the effect of needing excision of excess skin due to skin hanging below umbilicus and down over the pubic region causing skin rashes and vaginal yeast infections, stating "As you can see this is not a cosmetic procedure, but a much needed reconstructive surgery to ease my patients infections rashes and back pains." they listed several over the counter medicine and creams that i had used, A&D ointment, blue star ointment, Johnson & Johnson baby powder, corn starch, ETC..  good luck with the letter!

                      Jen 
  

KellBell
on 10/5/07 12:47 am - Lexington, SC
Thanks for the advise....I have written my letter to go with my surgeons letter.  I even used some the the verbage that you guys suggested. Now it is a waiting game. --Kelly

   KELLY  (309/171/150)

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