Question:
bsbc of michigan - tummy tucks

I'm considering having a tt surgery. Just found out that bcbc doesn't preapprove this surgery anymore. They surgeon's office insurance rep feels that i meet all the bcbs critera and doesn't forsee any problems. I'm a little nervous about this. Has anyone been told this by the surgeon's office and after surgery found out it was denied?    — lynn P. (posted on August 3, 2005)

August 3, 2005
my bcbs is through GM, and I submitted a letter of medical necessity from my pcp and my plastic surgeon and I was Pre-approved.
   — wizz40

August 3, 2005
I have BCBS in NC and went through the process. It took over a month and I was denied. The scary thing is, according to the surgeon, the insurance will decide whether or not to pay only after your surgery. Imagine going in thinking you are covered and waking up to a $7000 bill. Anyway, I guess I now become self pay, which is pushing anything I want done WAY in the future. Best of luck to you!!
   — thecobles

August 3, 2005
I have BCBS PPO of Michigan. I was told I was preapproved by my surgeons office after BCBS send them a letter saying they don't do preapprovals. I had my tt on 8/11/04. I then received a bill from the hospital for $22,000.00. Apparently the hospital thought I would be denied by BCBS so they just sent me the bill. The surgeon's office stepped in and forced them to rebill BCBS and it was covered except a $400 co-pay. I was told by BCBS customer service last year that if I had lost over 100 lbs. and was having yeast infections in the folds of the skin that my pcp was treating me for then the surgery was covered, just not any muscle tightening. Luckily I didn't need any work on my muscles. I hope this is helpful.
   — ckreh

August 4, 2005
I have BCBS of Mi. and had my TT & breast lift in March. My doctor told me if you lose 100 lbs. it is automatically covered regardless of rash or anything which I didn't have. I only had to pay for the breast lift (dr. portion)which was $3000.If a certain amount of breast skin is moved it will cover it too. I think it's 500 cc's. I didn't have to pay anything out of pocket for the TT. I see you're in Brighton, I'm in Milford. The dr. that did mine has an office in Novi close to 12 Oaks Mall. His name is Dr. Eti Gursel. Good luck.
   — kkubinski99

August 4, 2005
I see that our problems with BCBS in Texas are no different than anywhere else. They seem to be rather unpredicable. I have had to have patients cover their costs up front and them reimburse whatever INS pays...if anything...after the surgery. I honestly do not understand why they cannot see the photos of rashes and prior doctor visits and simply agree to cover the rocedure
   — DrL

August 4, 2005
I see that our problems with BCBS in Texas are no different than anywhere else. They seem to be rather unpredicable. I have had to have patients cover their costs up front and them reimburse whatever INS pays...if anything...after the surgery. I honestly do not understand why they cannot see the photos of rashes and prior doctor visits and simply agree to cover the rocedure
   — DrL