Documentation for insurance purposes

Hi!  I am new to this board and just starting to read and get as much info as I can!  I still have a bit of weight to go but already started having some skin issues.  I have hanging skin as well. 

I called my insurance company who will pay 100% of cosmetic surgery with PCP preauthorization.  YAY!   I started taking pictures of my belly when I had the issues but never went to the doctor for them.  Gold Bond powder is my friend. 

I'm sure that they will accept the pictures and keep them in my file but is there anything else that I could do in the next few months to help the approval process??  Did you see your PCP for every pimple, rash, etc?

Good luck to you with your procedure and getting the approval. It's great that your insurance will cover it. I think that you are doing the right thing with taking the pictures but I have no idea about how the documentation procedure works. I wish you the best of luck.

 

I have approval - surgery on 3/10.  When I called my insurance company, the answer I got was "it depends on the coding" and they had me schedule a consult with a surgeon.  BTW - I never called it cosmetic - went with reconstructive.  The surgeon took the pictures and did all of the submission.  I had never seen a doctor for my skin issues - treated myself with medicated powders and lotrimin.  Got approval in about 2 weeks.  Much easier than getting approved for wls! 

Thank you!  The person I had talked to at Capitol Blue Cross actually called in cosmetic.  I do like reconstructive better though.  I never thought that I would have WLS, let alone plastics!  Good luck with your surgery! 

I have bc/bs of VT and the person on the phone kept calling it cosmetic too - I just corrected her.  I figure that they probably record those calls and look for reasons to deny a procedure.  I could be wrong - and they were fast to approve mine - but it's hard to assume the best from a health insurance co.

I hope you get approved too!

Laura

It was a covered benefit for me too.  I actually never had any skin rashes or documentation and still had no problem getting it paid for.  I did have back problems which were caused by the hanging skin and it was documented that I went through physical therapy to help my back and the pain just came right back.  Good luck!


Laura

Ohhh I am so glad you wrote that about your back!  I always loved going to the gym, even at 300lbs, so of course I have been even more obsessed since surgery.  In November I started having issues with my back and therapy hasnt helped one bit.  I really would be having PS for medical reasons...that's just another to add to my list.  I am going nuts because I think I have more medical issues now than I did before.  *sigh*

I hear ya.  I think it's common to have a lot of aches and pains as our bodies go through such a huge change.  I was having sharp shooting pain when I worked out and this is what helped me get it covered....because it was interfering with exercise.  So it should help you out too : )

Laura

It really depends on your insurance.  I have to have 3 months of DOCUMENTED problems that are not resolved with medical treatment.  So I have to go to my PCP each month with a complaint.  He documents my medical records and prescribes me a cream. 

I have my first plastics consult next week.

That is really great... what a blessing.

I am especially happy to hear this good news because I was denied today so I am devastated but the good stories help because what can you do except move forward and keep trying. It lends some hope about the different insurance companies & policies, requirements.

So document away and go for it. Your plastics office can also help guide you with exactly what you will need providing they have a skilled insurance person!

Best of luck! 
L