Trying to get the Plastics ball rolling... Am I doing it Right??

 So I saw my PCP last week who basically told me Ins. will not cover for me to have plastic surgery on my tummy. I have an apron that comes around to my side and looks like a sidways 3 lol. I believe it is causing me lower back pain if this is at all possible. I do sweat in the fold and have an odor from that with occasional itchiness. But I have never noticed any redness/rash. Anyways, I called my insurance company to see what was needed as far as criteria for them to cover and I was told my PCP needed to call Provider services and they need to find out what is needed for medical necessity (prior authorization?). 

I was also told that it doesn not matter what plastic surgeons are on the provider directory. And if I understood her right she said that if it is deemed medically necessary I can go to basically whoever I want?? I have HMO Blue Option. I just switched to them.

I am just wondering if I am going in the right direction with this? I am giving my PCP until Weds to get ahold of Provider services until I call them back. My PCP office is not very good with doing this. If I have to call Weds. I am going to make an appt as well. 

You are on the right path. Have your PCP document your weight every time you go in, and document the odor and rashes. You'll want to go to the doctor at least once a month. Some insurances want to see 6 months stable weight and documentations of rashes, and talk to your PCP about it being medically necessary.

  I've got the stable weight thing down, I have only lost about 4 lbs in the last 6-8 months. My bariatric Surgeon gave me a RX for nystatin and I believe some other med. for Rashes but I dont have any but she said we would document it anyways. When I told my PCP that she said thats falsifying information?? I hope she isn't going to make this difficult. I know I am never going to be able to pay out of pocket for any of this so I am hesitatnt that this is never going to happen for me.

Have you asked what it would cost without insurance? My panni was covered, but the abdominoplasty and lipo was not (everything above the waist). My plastic surgeon charges more to the insurance company than they do to an uninsured person. I only had to come up with $1500 to pay for the surgery. It's worth a shot to inquire. :)