Question:
My insurance company approved my panniculectomy as medical nessessity, but disallowed

$2500 of my surgeon's $3700 fee. I need to know what others may have paid for this procedure before I file a greivence with my insurance. Thanks Barbara Trapp    — Barbara T. (posted on November 21, 2002)

November 21, 2002
if you have an HMO or PPO this is becasue your surgeon has a contrat with them that allows him ot do this. you should see how much of you RNY surgical bill was disallowed. Do not let the surgeon bill you for the diallowed portion of this.
   — Vicki L.

November 21, 2002
I had my panni last Friday, the 15th. My insurance company covered all the expenses. I am with PacifiCare HMO - they also covered my bypass. I am blessed with a very caring PCP who took all the proper steps for my approvals.
   — connie m

November 22, 2002
Was the doctor in network? If so, what grievance would you have with your insurance company. The previous poster was right. If you have an HMO or a PPO and the doctor is in network, he has an agreement with the insurance company and whatever they pay, he has to accept. I had a $30,000 hospital bill for my gall bladder surgery and my insurance paid less than $8,000. However, the hospital was in network, so I only had to pay 10% of the bill.
   — garw