Question:
How do I get PS to submit to my insurance company for TT???

He says I do not qualify for insurance coverage-but I would prefer if they said no than to assume they will say no. Can i submit to the insurance company myself and if so does anybody know ow I will go about doing that??? The PS fee is 8000 for abdominoplasty-I'm broke-HELP Started at 388 down to 238 and 2yrs PO    — TotallyTori (posted on March 24, 2005)

March 24, 2005
Call your insurance company and ask how to proceed.
   — Kasey

March 24, 2005
Most plastic surgeons won't submit GOOD letters of medical necessity - if they'll even do it at all. They want their FULL fee rather then the reduced amount they'll get from the insurance company. Have your PCP write a letter, you also need to write a letter and tell of the problems that your having. Take pictures of the excess skin (stand to the side, grab your stomach and pull the skin out in the front of you as far as it will go) and then take the picture. Check out other plastic surgeons as well. There are doctors who will write medical necessity letters. Also let the doctor know that this won't be a ONE time surgery like most people have. You will probably be having more surgeries which the insurance WONT pay for. Sometimes there more willing to write letters for repeat customers (or if they think you will be).
   — Patty H.

March 26, 2005
I went to more than 1 Ps for consults. One was very snooty and high priced and wouldn't submit to ins, Until I notified his office I had scheduled with another surgeon, then they sent the paper work right away.( I did not go to that surgeon) The surgeon I had the surgery with said - sure, no problem, he would try and that he had been sucessful many times in the past getting approval. he took photos, and carefully inspected my skin for any signs of breakdawn , etc. I was approved fairly easily after the ins got the photos. A big criteria for me is board cerification of the PS by the ASPS. price did matter to an extent, I could have gone to brazil of costa rica for a fraction of the price, so I didn't go to the cheapest one, I also didn't go to the most expensive one. After certification the next important thing was recommendations from others. That he would not staple my incisions, and his personality. I have been in his office at least a dozen times for preop and followup, and that was with no complications. he is VERY thorough. If I hadn't liked him personally it would be difficult to work so closely with him. Good luck. Keep looking until you are satis fied that the Dr. will take good care of you and will work with your ins.
   — **willow**