I have a rash!
I have been denied by bcbs of IL due to insufficient documentation of chronic rashes. Which I have had, but always treated it at home with OTC remedies. I was extremely embarrased to go to my doctor due to a rash caused by my excess skin and fat. Now I regret it. I had great letters from my pcp and chiropractor stating that my chronic lower back pain would improve if I had the excess skin removed. According to insurance, not good enough, i have to have a rash.
Today, I have a rash around my belly button so I called my pcp to see if I could come in so they could document it. Hopefully this will help with my appeal but my tt is in 48 hours! What happens if the irritation is still there? My heart will break if they have to postpone the surgery. Any thoughts?
Today, I have a rash around my belly button so I called my pcp to see if I could come in so they could document it. Hopefully this will help with my appeal but my tt is in 48 hours! What happens if the irritation is still there? My heart will break if they have to postpone the surgery. Any thoughts?
Kim
272/169
5'4"
272/169
5'4"
I don't know about your surgeon, but mine told me flat out at my 3 week pre-op visit that if I had a skin rash on the day of surgery he would not do the surgery because the risk of infection goes SKY high, even if the rash is not close to the incision area.
Call your Plastic Surgeon right away and tell him about the rash, and what you are doing to get rid of it and see if he will do the surgery anyway, you may have to wait until the rash has been gone without medication for 48 hours.
Also check with your insurance company about the appeal process. My insurance company will not even consider an appeal if the procedure has already been done. If you are serious about getting Insurance to cover a part of this you may have to postpone the procedure until the appeal process is complete and a decision has been made.
Call your Plastic Surgeon right away and tell him about the rash, and what you are doing to get rid of it and see if he will do the surgery anyway, you may have to wait until the rash has been gone without medication for 48 hours.
Also check with your insurance company about the appeal process. My insurance company will not even consider an appeal if the procedure has already been done. If you are serious about getting Insurance to cover a part of this you may have to postpone the procedure until the appeal process is complete and a decision has been made.
Anna
RNY 10/14/08 LBL 6/14/11 135 pounds lost, after bounceback regain. And I am OK with that. It enabled me to have double hip double knee replacements in the 9 month periond between Oct 2011 and June 2012.
I don't know about the rash and having surgery.
I do know that, in most instances, if you go ahead with the surgery you basically forfiet your right to appeal or have insurance cover it. It has something to do with it being deemed a totally elective procedure at that point (since there has been no approval) AND with how hospitals bill for cosmetic vs medical procedures. So, if you want insurance to pay anything, you're most likely going to have to post pone the surgery until AFTER you get approval.
I do know that, in most instances, if you go ahead with the surgery you basically forfiet your right to appeal or have insurance cover it. It has something to do with it being deemed a totally elective procedure at that point (since there has been no approval) AND with how hospitals bill for cosmetic vs medical procedures. So, if you want insurance to pay anything, you're most likely going to have to post pone the surgery until AFTER you get approval.
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