BCBS LBL Coverage?

 Has anyone had success with having surgeries other than abdominoplasty covered with Blue Cross Blus Shield? I'm BCBS of Michigan.
My issue is my skin no longer heals... So, every scratch, nick, or bite that occurs along any skin fold simply swells, gets a dark ring around it, and refuses to close...Startin' to feel like a leper here..;)

If yes,
What documentation was required? How long did the approval process take? What surgeon did you go through? Did you have specific medical codes used in your report?

Thanks!!  

~AnneO

BCBS of MIchigan Jacked me around.  For the first 6 months they told me the only requirement was having had surgery, being 6 months out, and having lost 100 lbs.  

After I got close enough to schedule surgery they added in new requirements to determine that it was medically necessary.  I had to have documented rashes that would not respond to treatments with cream, the panni had to hang lower than the pelvis and documented hygiene issues.

The approval process took months.  I had to start having daily phone calls with executives.  They lied to me constantly, gave me the runaround.  I am in the appeals process, and my next step is an external appeal under the provisions of the PPACA.

Have you'd PCP and your plastics guy write up, photograph, and document everything.  Make sure things are documented not only by diagnostic codes entered in your record but chart notes as well.

Expect a fight.