omg im pissed! -UPDATE

okay so today i went for my consultation with Dr. Lovett.. whom i really liked and am looking forward to doing business with this PROFESSIONAL place of business. UNLIKE the original doctor i was supposed to have plastics with! while talking to the dr. today he was quite shocked, and i really dont think he believed me when i told him i was approved for the panni removal. (since i dont really have a "PANNI" hanging low) well i told him i was and yada yada.. so i came home tonight and went on my insurance company website,,logged in to check the "status of authorization" and there it was still "Approved" for TWO procedures it says.. one says "

Service Location:			INPATIENT HOSPITAL
Service:			15830 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOU
Units:			001

the other says ..

Service Location:			INPATIENT HOSPITAL
Service:			15847 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOU
Units:			001

Well before when i saw these i just figured it was medical mumbo jumbo meaning REMOVING THE PANNI... Since the dr i saw told me that the insurance wasnt covering the "adominoplasty" portion that i had to pay OVER 4 grand for THAT part not covered.. Well upon my researching tonight i find this website: http://www.plasticsurgery.org/medical_professionals/health_p olicy/loader.cfm?url=/commonspot/security/getfile.cfm&PageID =18091 WHICH CLEARLY States the codes for these surgeries .. I was 1) Approved for the panniculectomy and 2) APPROVED FOR THE ADOMINOPLASTY!!! the SAME procedure that i HAD PAID over 4 grand for out of pocket which he was ALSO sumbitted to my insurance company for payment and i did not know about it. Not to mention the fact that this new doctor i am paying not even a quarter of the price for my breast lift AND augmentation together that i had paid the previous doctor for JUST A lift!  THANK GOD I cancelled the surgery with the previous person whom I will be telling Dr Bour about since he recommended him to me! Not to mention when i was signing my informed consent with them, he had on there "hernia repair" and at the time, I HAD NO HERNIA.. so he was double dipping the insurance company again! and THAT my dears is why insurance companies do not like to approve plastics.. because there is so much fraud involved with doctors like this! im livid. Had i paid all the extra money and found this information now, I would be sueing that doctor for FRAUD. Anyone knowing alot about insurance can you confirm that this is true?? im hoping to call my insurance company tomorrow and "Change the doctor on my approval" and cross my fingers it will be that easy and i wont have to lose the approvals, bc this doctor doesnt seem to want to file to insurance. he doesnt think i will get approved.. although i was somehow! anyways i had to get that off my chest.. NOW I WISH I SMOKED!! I miss my cigs at moments like this when im so pissed off!  *SIGH* the dr today had me talking into the belt lipectomy, but if insurance will pay for this other and muscle tightening and all that then i will just take the tummy tuck and run! i dont have the money for the other now. .so it can wait !  love yall hope everyone is doing well! **UPDATE** I talked with my insurance company and it WAS approved for EVERYTHING.. the doctors office was charging me for the abdominoplasty KNOWING that insurance was going to be paying for it also.. so it was them trying to rip me off for that money. and that i can get my new doctor to send a letter stating he will be doing the same codes and request a re-approval .. so hopefully it will all work out for the best.. and i will be letting the prior doctor know that i know he was ripping me off at some point .. ergh.

Good luck Jen.  I definitely have the panni...age and kids will do it to you.....but insurance had a "specific exclusion" and wouldn't even consider it...so out came my plastic..... 

ok... so heres the thing about that auth....  your dr did lie, cheat and still to get the auth... which is absolutely NOT a good thing. However... #1: he himself doesnt submit for auths, his nurse or assistant or precert chick does. I would assume that he trusts them and doesnt double check what clinicals they provided.

and #2 sometimes the dr staff know the insurance companies so well that they know what NEEDS to be on the request in order to get it approved. So they might overindulge in order to get an auth for the benefit of the patient It sucks, but its the truth. Its the reason why some companies ask for pictures and CT scan results before authing TT's. Sorry! And often times, just because they authed both doesnt mean they would have paid for both. You wont know that until your claim is paid. Sometimes one procedure is considered incidental to the other one and only one is paid. Or the first one is paid in full and the other only paid at 50%... b/c of a multiple surgical procedure clause.  A good Dr's office will aim high and then take what they can get. Worst case scenario would have been your insurance paid for both and he owed you some money...  be cool. Youre on your way now and will look trim and fit with your six pack when its all over with!

I'm glad your visit went well with Dr. Lovett. I was very happy with everything they did for me there and have no regrets at all. I know your pissed about the "other" doctor, but it just confirms everything I had already heard about him from my co-workers. I would love to have had mine paid for by the insurance, but I am not the type to take chances with fraud either. My insurance company required pictures and even though my panni hung down he didn't think it would get approved without the documented skin rashes/breakdown. I just didn't feel like hasseling with the insurance over paying. Since I had it done at their surgery center I did save a bunch and would have been looking at an additional 20,000.00 if I had it done at the hospital instead. Hell I can take my own pain meds and blood pressure, lol, and Dr. Lovett called me  at home that night and the next morning to check on me, so to me that's no different than the doctor coming in the next morning and telling me I can go home and then having a big hospital bill to pay later. I think you will be pleased with just the tummy tuck, and your recovery will be a little easier not being cut all the way around like I was. Let me know when your having the surgery. Love Ya girl! Mary

what doctor are you using?  is he cheaper on the TT too?

crap i got so into reading i forgot the first line!!!

Jen, You are gonna have to call me, I TODAY had an appt with the other doctor since I was denied 2 times by the other docs and thought since you got approved I would give it a shot. I want to talk with you to make sure I understand what this is about. Patti hm 234-5549