Question:
Approval time with tummy tuck

I was just wondering how long it took to get a response (approval or denial) from your insurance company after the palstic surgeon sent in letter for approval? Mine sent a letter last wednesday for a panniculectomy. Im just curious about how long I may have to wait to hear something. I know all Ins. Co. differ. Thanks.    — Carrie W. (posted on June 12, 2004)

June 12, 2004
I used to work medical review for PS + WLS. We had 1 month to get an answer out. Best of luck!!!!!
   — ZZ S.

June 12, 2004
It was about a week. I called the surgeon's office and my insurance company just to make sure that the ball kept rolling
   — Michelle H.

June 12, 2004
It took me two months. The surgeon submitted a letter within a few days of my visit. I called BC/BS two weeks later to follow up, and was told I needed to give it 30 days. At 30 days I called BC/BS again. They said they had just reviewed the surgeon's info, but needed more info and pics. I phoned the surgeon's office and had them send in the requested info (they never got their copy from BC/BS). I caled again in two weeks and was told I had to give it another 30 days. I called again at the 30 day mark and was told it had been approved that morning. It took another week for them to get an approval letter in the mail. The copy to the surgeon's office never got there (again), but they took a fax of mine. Based on my experience, my advice is to follow up with both the insurance company and the surgeon's office--don't assume the two are actually communicating. Best wishes for approval!
   — Vespa R.

June 12, 2004
Took a week and I had surgery from consult to surgery day in 2 weeks! I Love the new me!
   — Hazel S.

June 12, 2004
In NY, the law is 30 days. I heard in just that amount of time, and started my first appeal right away. After my second denial which was around 2 weeks later, I began my outside appeal with the State of NY. That took 3 weeks, but could have taken up to a month. I am due to have my TT in the middle of August. Good luck!
   — Fixnmyself

June 13, 2004
I had to send pics in again but this time with no clothes covering the pubis. I personally sent these myself saving time and not having to go through the doctor. BTW my wls surgeon performed the tt and hernia repair and in my opinion did a better job than what I have seen in the plastic surgery pages. Getting back to the tt question, I was scheduled for surgery in 2 weeks before I sent them in and they told me the next week after getting the pictures. 3 weeks before they had to. One bit of advice is get to know someone at the insurance company. When you call them and call them often, get to know one person well. Ask for them, and send the pics and anything else you need to send them, personally to that person at their office. They can help you confirm that they got them. Get on a first name basis. I think this helped me get approval so quickly. Hope that this helps. Patti
   — classydame1

June 13, 2004
Hi. It really does depend on the company and the degree of problems you have documented, and the photos. If you have photos showing a large amount of skin, a rash beneath that skin, papers showing prior visits to your famiy doc describing the skin problems you've been having, you can expect approval within a month. Lacking all of these things, a several month process is not unusual. That's why I ask patients to come in soon to start the process...even if they are not at goal yet. This also gives them a chance to hear abount any out-of-pocket expenses and prepare for that if needed.
   — DrL

June 13, 2004
It took only 6 days for my insurance to approve after receiving the PS predetermination letter. My HMO is hard to work with so I about fell off my chair when the approved so quickly. It was my second time trying for a TT. I had all my ducks in arow this time. When you PS files the predetermination letter include your medical necessary letters and medical records documenting your claim for either back pain or rashes. Insurance company's want proof. Give it to them up front, it's easier then trying to go through their hellish appeal processes. Good luck
   — bbjnay