PS denied 7th time

Well I was not expecting an approval...ok I was... BUT I ask the lady from insurance who called me to say I was denied what all they got. 2 pictures and a letter of request from the PS. I said ummm wheres the 4 letters med nessesity,2 years drs documentation and all the other stuff?? LIKE my previous AUTHORIZATION LETTER??? So I call the PS office... hmmm first they forgot to submit alltogether... Now she forgot all the stuff. So now I got to appeal... this is gonna be fun!!! THEN the lady at the PS office says.... "TRICARE will not and does not cover plastic surgery" Ummm And it don't snow in Buffalo??? Oh well such is life! any tips? Im not upset over this... As IM too busy with repairing home and thinking about my husband, cysts thyroids.. engine falling out my truck... LOL

Most PSs are not motivated to work with insurance companies. When they perform services for insured patients, the amount of reimbursement is considerably lower than what they receive from their cash customers (I mean patients). Hypothetically, if you had a choice of working for $5 an hour or getting $20 for the same work and do it with far less hassles, what would you choose? Few competent PS are lacking for cash paying patients, so making the choice for the surgeon is a no-brainer, especially with the line of prospective customers winding around the block. I wi**** were not so, but that does not change a thing. Nowhere Man/PH/Jay

OH I know this, It is amusing that I was approved with a top notch one. But I do not have the 6 k that would be my cost. In time. if not,... Im to the point of whatever ya know? But i KNOW alot of people with TRICARE getting approval left and right

I chose a Plastic surgeon that was suggested by my WLS program. The group had done several weight loss people and were very supportive with working with insurance. I did though have to be proactive, rashes, back pain, shoulder, hip and neck pain from apron. Documentation is the key, but also finding a provider that is sypathetic to people with huge weight losses help. They usually can anticipate the hoops you have to jump through. Just my experience, hope it helps. Stacey