plastic surgeon in Tennessee

BROWNEYES_24
on 11/10/12 6:45 am

I have bcbs federal and I want to know if they cover plastic surgery, I need a full tummy tuck,upper back lift,arms and inner thigh done. What exactly will insurance pay for if I can say its medically necessary.

rhearob
on 11/21/12 1:46 pm - TN

You will need documentation that it is medically necessary - that usually means:

 

1.  Documented skin rashes that can not be managed with medications

2.  Panni hanging below the pubis

3.  excess skin causing musculoskeletal issues (i.e. lower back pain) that has been documented by your physician.

 

BCBS has a HORRIBLE reputation with plastic surgeons for agreeing to pay and then pulling some crap to say that something is not covered.  My surgeon will not schedule with an insurance patient unless the insurance company sends a pre-determination letter.  You can do the consults and get the surgical plans, but surgery wont be scheduled until you get thet predetermination.

Start the process with your PCP - get everything documented in your charts with the proper diagnostic codes, not just chart notes.  Then get copies of your charts and chart notes. Documentation is the key.

_____________________________________________________________________
 160 lbs lost. Surgeons Goal Reached in 33 weeks.  My Goal in 37 Weeks.

VSG: 11/2/2011; LBL+Thigh Lift+BL: 10/3/2012; Brach+Mastopexy:  7/22/2013

Iam_with_the_Band
on 11/21/12 2:14 pm

You might have a better chance getting your insurance to pay for a pannectomy.  It is rare for them to pay for other procedures.

12/09 and 6/11, 9 skin removal procedures with Dr. Sauceda in Monterrey Mexico
Revised to the Sleeve after losing 271 lbs with the LapBand. 

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