Tummy Tuck...Did you have to pay out of pocket for your belly button?

I am happy my insurance is paying for my tummy tuck and my surgeon doesnt charge ME for the abdominoplasty part of the procedure but I was surprised to read I have to pay 560 for a belly button since insurance doesnt cover that part.  Did you pay out of pocket for yours?

What will these cheap-a$$ insurance companies think of next to screw women?  Frankly, I think it's outrageous.    I was a self pay and I'm sure I wasn't charged extra for a belly button. 

No I don't have to pay extra. It's included. My surgeon is very nice and doing extra work without charging extra.

It absolutely cracks me up that the same people are so fast to blame the insurance company over and over again. This charge IS part of the TT and should not be charged extra for and IS included in the payment from the insurance company.

My ? to you is this.... since you stated that your provider is not charging you for the abdominoplasty part... Does your provider participate with your insurance plan? If no, he has the right to bill you what ever he wants and then you would be responsible for any charges after the insurance carrier payment.... If he does participate then may I suggest you contact the provider relations department of your insurance company (you can reach then through your customer service department) to inquire as to why your participating doc is billing you separately and in addition to their payment for the belly button... I would then have someone from their office contact your physician on your behalf to decifer why there is the addtional charge.

Good Luck !!

 

 

Hmmm..I will definitely be checking into this!  I do know my insurance does not cover a tummy tuck per say..that is why it is submitted as a panniulectomy...will be giving them a call.

The codes for abdominoplasty and panniculectomy (15831 and 15834)  are "surgical resection of the overhanging "apron" of redundant skin and fat in the lower (or upper, in the case of Aplasty) abdominal area."

http://www.medem.com/?q=medlib/article/ZZZ4W6H5EAC

Liposuction, muscle tightening, and umbilicoplasty (new belly button) are not covered in the code and could be billed separately.

Billing patients outside of what insurance covers may raise questions about what the plans allow per the contract with the doctor.  Hence, many doctors do not contract with the plans.

Realize that if insurance covered procedures that were a lot of extra time and work that resulted in beautiful, contoured results (via liposuction, muscle sculpting, and cretaing an attractive belly button) then all PS would have patients waiting in line for this.

The reality is that INS companies feel their dollars are better spent paying for other, more pressing health concerns.   

Makes sense.. I was just surprised to find it on my bill of all things.. All in all though I am extremely thankful I am getting this procedure at such a low cost to me :)

Dr. L explained it perfectly... It sounds like you've been approved for a panniculectomy but have opted for an abdominoplasty. If this is the case, I would be very careful. As Dr. L explained, they are 2 different procedures billed for with 2 different codes. Legally, a participating doc can not do 1 procedure and bill for another. It has to be 1 or the other. Either the insurance billed panniculectomy or an out of pocket abdominoplasty. We have been cracking down on our participating PS and auditing them. When we determine this is what has been done, worst case scenario is we have been terminating them from our network. 

Hi Inkerdoodles. I have a question...

if an out of network doc submits for a procedure and then bills or charges the patient directly for something that was not included in the CPT code (i.e. liposuction) does that raise a red flag ?

absolutely not.... An out of network physician can basically do what ever they want because there's no legal contract with the insurance company. If an OON provider chooses as a 'curtosy' to bill the insurance company for what's covered that is strictly a curtosy between the dr and the patient.