Tummy Tuck - Not too happy - Gallbladder scar

I had a tummy tuck the end of January 2009.  I am 50% happy with the results.  The main issue I have is that my surgeon was unable to pull down from the wait line, and now I have smaller hips than I do middle area (aka muffin top).  His exactly word were: he could not be as aggressive with the area above the waist due to my gallbladder scar.  Unfortunately I took the words NOT AS AGRESSIVE to mean he would be able to do a little even a 5% change would have been better.

On top of all of this, I had a very small hernia to which he repaired.  The hopsital situation has been a nightmare.  I self paided the tummy tuck, and the hopstial and doctor's nurse said the hernia would be submitted to my insurance.  No one mention that this would be out of network for my insurance (I would have thought they might have mentioned that!).  It took me making phone calls until April to get them to even sumbmit a bill.  Once that was done, and keep in mind this was suppose to me only the hernia portion, they submitted a bill for $30K!!!

I am postivie this is an error,but you cannot get anyone at this supposed 5 star hospital to help to sort this out, the bill included all of the items used in the surgery instead of just portions.  But naturally no one seems to care.  So now after adjusting the bill,and my insurance paying $13K they say I owe $7K.  I paid $10K for the tummy tuck portion, surgeon bill included, and I just cannot believe now that I owe them another $7K for the hernia, which was so small my surgeon did not even file on my insurance, as he said it was so minimal.

Let's just say this is my nightmare!! I have no idea how I can come up with another $7K after saving for 4 yrs to have this tummy tuck.  (my gastic was in 2005).

Be sure that you check out the difference to just self pay all of this type of thing... I had no idea I could have even done this as they hospital offers no help or suggestions at the time of check in.

Also if you have a gallbladder scar, long ways across your abdomen be sure you understand that it might be that they cannot do or will not do anything for you loose skin about the waist and you might end up with only 1/2of what you really needed.

Sign me disapointed, and very upset about this bill !!

SORRY TO HEAR ABOUT YOUR TROUBLES. I HOPE U CAN WORK OUT SOME RESOLUTION TO THE PROBLEM. VICK

You know Sandra you really have to be an educated shopper with this stuff don't you?  That same thing almost happened to me.  I went to the first ps and he told me the panni removal would not be covered by OHIP which is our Provincial plan.  I did not go with that doctor not because of that but because he answered JUST the questions i asked but never offered any information He was really telling me i needed breast implants also. Well face it the greatest percentage of us have never gone through this before.  I went for a second consult with another doctor told him i wanted a tummy tuck and HE told me that is from the belly button down but if i wanted the skin removed above the belly button it was an additional $3,000.00.  He offered to save me the money if i wanted just the bottom part done. Well i wasn't going to scrimp on the money at that point so i did the top portion also.  Plus he submitted the panni portion to OHIP and they paid a portion and i paid the balance. 

What  i'm saying is i thought a tummy tuck would have taken care of the whole thing and i would have had the same experience as you if i had gone with the first guy because i didn't know enough to ask.  With my surgery the doctor told me ahead of time he didn't know if he could save my belly button because of a hernia i had done there years ago but he would do his best, so i went into it knowing i could wake up without it.  Gladly they were able to save it .  Also when i went back for my check up he told me when they did my breast lift they took a part and sent it away for a bi-opsy and everything was fine.  I was very pleased with the turn out with this doctor and going back next week for my last check up and scheduling surgery for my arms hopefully in september.

I'm sorry to hear your only 50% happy but congratulations on your success.  We have to all learn to be our best educator for ourselves. 

Wendy

Thanks Wendy.
I did a lot of research and had 3 consultations with PS in the area, all of them were concerned about the scar across the abdomen due to the open gallbladder surgery.  It seems that that is quite a challenge and can often lead to the area between the old scar and the new scar to die and become a wouden healling issue.  So I think the concern was valid, but I just wish the PS has been more clear about the fact that there was a possibility of him doing nothing rather than saying he would not be as asgressive as he would normal have been.  I also have hernia up high as well, due to this old open gallbladder but since I have had it for more than 15 with no issues, it was no repaired.  Anyway he did mention we could do a revision, and then he would pull down more. I think he realised that he could have done more, because I am a fast healer. But who want;s to go thru that all over again, and with the hospital bill issue,there is no way I could consider that anyway!

Congrats on your wonderfull loss!!!  That is amazing!!  I lost 180 but gained 20 back (lost the last 20 with a bout of illness)  So the total is 160 from my surgery. I still would like to loose another 20 but I am holding steady and I guess that is better than going up.

You are an inspriation.

Dear Sandra:

Sorry to hear about your situation, but as many of your friends have mentioned above, you really have to do your research when it comes to Plastic Surgery.  Going to someone who specializes in post bariatric and Body Contouring is always helpful to start with.  The open gallbladder scar is always  a challange for the Plastic Surgeon.  Honest communication is necessary at this point.  However, the patient may not always want to hear the Plastic Surgeon who talks about potential complications or an inverted T (Fleur-de-lis) abdominoplasty.  Instead a Plastic Surgeon that does not talk about these issues may be selected.  If you were my patients, I would have approached this problem by offering you 2 options: 

1) A Fleur-de-lis tummy tuck will give you longer incisions but in most cases can remove the open gallbaldder scar. 

2) A conventional abdominoplasty-  but you have to realize that your complication rate will be much higher since the abdominal tissue under the scar may have decreased blood supply and thus the wounds can open up.  If that happens, you will need dressing changes and a revision.

Also, always look at before and afters of the chosen surgeon.  Demand quantity and quality.  Do not hope that your surgery will be different or better....

Thank you for the feedback.  My surgeon is one that was very experienced in Gastric by pass paitents.  Of the 3 I consulted personnally with he was the most experienced.   Although he did not mention the fleur de lis option, he was very clear about the issues around my gallbladder scar.  I think sometimes wording is very important, and I have faith that he did what he felt was possible at the time.  No surgeon would take the word of a paitent that they tend to heal faster than normal persons, and thus the he was likely at bit more cautious that I hoped for.  But as with any surgery there is a risk that it will not be what was hoped for, the 10lbs that was removed looks great and there were no complications or pain. 

It seems that you had selected the right Plastic Surgeon and he he had done his best;  considering a difficult and challanging cir****tance.   

Your insurance problems sound like a real mess.  I don't know alot about insurance because all of my plastics were self-pay.  However, I just had knee surgery last month which was covered by my insurance.  Here's an example of a recent bill I received in the mail:

TRICARE Amount Billed:  $3.752.00
TRICARE Amount allowed:  $467.00
TRICARE Amount paid:  $467.00
Amount you owe:  $0.00

My insurance company told me that I am not responsibile for anything above and beyond what my insurance agreed to pay.  My surgeon cannot bill me for the balance.  The hospital bill was similar to this one.  If the insurance company can get away with paying only 12% of the bill, why should a private party be stuck with paying full charge?  

I'd try the "my insurance company told me that I am not responsible for anything above and beyond what they have agreed to pay you"  approach.  If that doesn't work, then I would negotiate hard - try to get them to agree to something reasonable - like 12% - $840 in your case - and make sure they issue you a revised bill showing that amount before you pay it.

Good luck.  And I'm sorry things didn't turn out better, all the way around.   

Thanks Big City Girl.
I am calling as much as I can to sort this out.  Yesterday I finally got hold of someone who has told me I should only be responsible for the estimate given at the time of checkin.  So I am now waiting until Wed to call and see if she was able to make the adjustment.    Live and learn!!

There are patient advocates available at hospitals -- make an appointment and tell him/her about your situation.  Another good idea is to go in and talk with the billing people and see what they can do.  I've done that before and they literally wrote off thousands of dollars of expenses.  Also, check with whatever state or national agency oversees hospital billing issues and grievances.  I hope it works out for you.