Plastic surgeons that accept insurance?
Hi everyone, I still have about 60 lbs to lose until I'm at goal but I'm going to be looking into plastics, I do have insurance that will cover some plastics if medically necessary, I was just wondering if anyone knew of surgeons in Ohio, preferrably near Dayton that accept insurance and will work with them for approval. I have posted before on the Plastic Surgery forum and did get a recommendation for one in Cincinnati but I know you are supposed to get a few opinions, so I thought I would post here to see if anyone had any advice. Thank you in advance!
Realize Band-12.1.08 Revision to VSG-6.27.12
I truly wish you luck with your search for someone in Dayton who will take insurance. A couple of years ago when I was looking to have my panniculectomy done, I called literally every single plastic surgeon in town who was on my insurance plan and every single one said that THEY considered it "cosmetic" even if the insurance would deem it medically necessary, and the best they could do was for me to pay them 100% out of pocket and then have ME submit it to the insurance company afterward and accept whatever insurance would cover. In other words, they will only do it for full fee; they will not accept the reduced insurance contract amount (which, in my case, was about half of what was billed (insurance paid a little more than half for the surgeon but much less than half for the hospital charges)). My friend Robin from her warned me about this (she encountered the same problem).
I was extremely lucky and found a PS who had just opened a new practice and was willing to do it with my insurance. (The only way I found him was to call the insurance company and ask for any PSs who had recently been added and were not yet listed on the "physician locator" portion of their website.) Unfortunately, a friend of mine called him a few months later only to find that he, too, had joined the other PS in refusing to take insurance for a panniculectomy.
Perhaps you will have better luck with your insurance. (Unfortunately, the surgery then becomes a matter of who WILL do it, not who do I WANT to do it. I was glad that when I had my arms done (NOT covered by insurance) I then had a choice of surgeons.)
I would recommend that you just start calling all of the PSs that are covered by your insurance plan and ask if they will sumbit it for insurance (but prepare yourself mentally to be told "no"). I don;t know why the PSs in this area have banded together on this (I have friends in other states who have not had this problem), but it was a very frustrating process because I started out with the assumption that if the surgeon was included on my insurance plan that they HAD to submit it to insurance for me. Wrong. I even called my insurance company anbd explained what was happening. They just told me that there really wasn't anything they could do if the surgeon himself did not deem it medically necessary (even without ever SEEING me).
Lora
I was extremely lucky and found a PS who had just opened a new practice and was willing to do it with my insurance. (The only way I found him was to call the insurance company and ask for any PSs who had recently been added and were not yet listed on the "physician locator" portion of their website.) Unfortunately, a friend of mine called him a few months later only to find that he, too, had joined the other PS in refusing to take insurance for a panniculectomy.
Perhaps you will have better luck with your insurance. (Unfortunately, the surgery then becomes a matter of who WILL do it, not who do I WANT to do it. I was glad that when I had my arms done (NOT covered by insurance) I then had a choice of surgeons.)
I would recommend that you just start calling all of the PSs that are covered by your insurance plan and ask if they will sumbit it for insurance (but prepare yourself mentally to be told "no"). I don;t know why the PSs in this area have banded together on this (I have friends in other states who have not had this problem), but it was a very frustrating process because I started out with the assumption that if the surgeon was included on my insurance plan that they HAD to submit it to insurance for me. Wrong. I even called my insurance company anbd explained what was happening. They just told me that there really wasn't anything they could do if the surgeon himself did not deem it medically necessary (even without ever SEEING me).
Lora
14 years out; 190 pounds lost, 165 pound loss maintained
You don't drown by falling in the water. You drown by staying there.
Not Dayton but in Akron.
Dr. Pederson works with the bariatric patients that go through Summa Akron City hospital.
A person I work with was assuming it would be self pay and Dr. Pederson got it covered and accepted the insurance. My co-worker is happy with his results. He had a panni or tummy tuck, which ever is the one covered as medically necessary due to rashes.
Dr. Pederson works with the bariatric patients that go through Summa Akron City hospital.
A person I work with was assuming it would be self pay and Dr. Pederson got it covered and accepted the insurance. My co-worker is happy with his results. He had a panni or tummy tuck, which ever is the one covered as medically necessary due to rashes.
Winnie
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