UHC denial for pani

CA_GirlRocks
on 1/11/10 7:35 am
Make a couple of calls yourself before spending the $ on an attorney... 

Find out if your company's policy specifically excludes Plastic Surgery - if so, I believe that you are out of luck. 

Call the insurance co and out what their criteria are for approval.   Some require a certain amount of time at a level weight, certain amount of skin hanging, skin issues (rashes), etc.  most companies willo tell you if you ask.

Good Luck!
Yolanda P.
on 1/11/10 9:02 am
The will approve reconstructive surgery. I call before and they said it had to be medically necessary. I will call them again tomorrow.
Yolanda

Sal2010
on 1/11/10 10:36 am - old forge, PA
Yolanda this may sound unpleasent but you want your letter to say you have rashes and oder from the skin on skin contact if you have documented uti 's that you were Rx ABT for this will help...
If you had yeast infections you want that there you are trying to prove that with all this skin you are harboring microbs that are causing infections inaddition to the back problems from it pulling on you.
hope this helps
Anissa
Yolanda P.
on 1/11/10 11:17 am
I am currently using a cream for rashes and oder my pcp order. Yes you are right the oder is so unpleasent. I believe that maybe all was not sent correctly I just have to make sure it's done right this time so it can be approved.

Thanks for your help.
Yolanda

cheshireji
on 1/12/10 1:06 am
Just letting you when what I found out......
When I was researching insurance the end of last year my choices were UHC thru Oracle (my Husbands' insurance) or Anthem Blue Cross (thru my employer).  I called each company to find out if they would approve the plastics for skin issues after wls.  The woman I talked to at UHC said that she had NEVER seen an approved claim for plastics, even when one person had lost 300 lbs.  Anthem said that they would cover it, so I went with them. 
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