Question:
I just went to see a plastic surgeon about and Panni, hernia repair and to fix a

congenital breast defromity that I have. He didn't do anything at the appointment. He took two pictures of my front and said that he needed to get the codes for insurance. He didn't even ask what problems I was having from the apron and he didn't tell what exactly he would do to fix the hernia or where he would cut for the panni. I am disappointed, because I feel like this was my one and only shot at getting approval and now I feel like I will be denied. I haven't been to my doctor about the rashes, and the pulling my apron does to my hernia, and the pain from that. Will that really help? I have Keystone HMO and was told by his secretary that they are the worst at covering anyhthing like this and he told me I shouldn't have a problem with Keystone. What should I do?    — Dawn H. (posted on April 29, 2002)

April 29, 2002
Dawn, I have had a similar experience with both my WL surgeon and the plastic surgeon. Neither really asked much about the symptoms I had. As it turns out, my WL surgeon wrote a fantastic letter to the insurance based on study data that showed how high my risk of obesity related diseases and early death was, and simply listed my co-morbs. I was approved for the WLS with the first letter. The plastic surgeon simply took pictures, told me he'd make me look like I'd done 1000 sit-ups and that I could schedule a date when I was ready. I've not done that yet, since family problems are keeping me from being able to have the surgery anytime soon, but I was told that almost all of their patients who are having reconstructive surgery after WLS have the same general problems, and that the surgeon's letter to the insurance company will document ALL of the problems that come from having WLS. So, maybe your plastic surgeon follows a similar procedure? In any case, if you are concerned, the best thing to do is call your PS office and speak to the surgeon or his staff regarding your concerns. They should be able to tell you what their procedures are for documenting symptoms and what type of letter they send to the insurance co. Good luck. Maria
   — Maria H.