Still in shock!
Hey Holly and Jackie,
I have BCBS. I got the criteria for each procedure faxed to me from the insurance company, then made copies for 3 different doctors who wrote letters of medical necessity for me, tailored to the criteria. (It was all true, but they used specific terminology that related to the requirements). I did the same thing when I was trying to get approved for the WLS.
It took 2 weeks exactly for the approvals. Even my PS wasn't sure about the TT - although she thought the BR would probably be covered.
It took some time to get everything gathered from three busy doctors, but it was worth taking the info to them, calling with nice little reminders, and trying to be patient to submit my claim until "everything" was together in one nice package. And now I am ordering them each gifts as a thank you - and even that seems trivial compared to the changes that have and will occur in my life due to their support.
I wish you both luck!! Every insurance company and their requirements are different. But I would say do your homework, be patient, and be thorough.
Crystal
Hi Holly,
I called them and asked what their criteria was for the breast reduction and abdominoplasty or panniculectomy. After reading it to me - and it was quite lengthy and involved mathematical equations (at least for the breasts), the lady said she'd just FAX it to me so that I could read it myself. And that was what gave me the idea to make a copy for each doctor, and for the plastic surgeon so everyone was aware and on board. She also FAXED me the prior authorization form they need filled out by the plastic surgeon to help expedite the process. It seems so simple, but it all came together beautifully. I hope you can get things to go as smoothly!
Crystal