Question:
I need help developing a rash for TT approval with hernia repair.
I have a huge hernia and a large apron. I have lower back pain but no rashes. Cigna is my insurance company and I was told that a rash sure helps with approval. Any suggestions? Thanks for your help! — blank first name B. (posted on March 23, 2004)
March 23, 2004
Purposely "developing" a rash for insurance purposes is insurance
fraud.
— Jim F
March 23, 2004
Sorry, but, it's not the best idea to ask for suggestions to defraud your
insurance company on a public forum, now, is it?
If you don't have chronic rashes, then guess what, causing one isn't going
to make any difference. The rashes/infections of the skin they are looking
for are a cronic problem that can not be solved with the use of
conservative measures, such as a perscription antibiotic. You can't FAKE
those.
— LMCLILLY
March 23, 2004
Not only is it insurance fraud, but it's disturbing that you would give
yourself a rash just to get approval for a tummy tuck.
I thought we were trying to make ourselves better, not worse.........
— ScottieB86
March 23, 2004
I have to agree with above posters, besides being dishonest it may not
serve you at all healthwise. You will be compromising your healthy skin
and may open yourself up to healing issues post op. If you have a hernia
and that may be covered by your insurance, discuss a self pay situation
with your surgeon for the TT during the same operation.
Good luck,
Jackie O.
— Jackie O.
March 23, 2004
I think that perhaps you were inquiring as to whether or not you could be
approved for the surgery without a rash and asking for helpful suggestions
as to how to best present your need for the surgery to CIGNA. Right?
Your best bet may be to ask your surgeon to engage in a peer-to-peer review
with a CIGNA doctor to explain the medical reasons for your panni removal--
given the size of your hernia, your development of lower back pain and the
likelihood of developing serious skin infections, your surgeon could
convince the insurance company.
— SteveColarossi
March 24, 2004
Uh, this sounds like fraud missy! Do the right thing, save yourself some
trouble down the road. :-(
— aprilbaree
March 24, 2004
If you have a huge hernia they should cover at least that part of it, I
agree if you don't have rashes count yourself lucky they are gross!!!!!!!
And they are an infection and you don't want that.
— Saxbyd
March 24, 2004
Cindy, YOU SHOULD BE ASAHMED OF YOURSELF....DEFRAUDING INSURANCE COMPANIES
is ILLEGAL! If I knew your last name was real, I would report you to
Cigna. GET A CLUE! Ins companies are now approving 50% less of RNY
paitents everyday then they used to b/c of people like you. I know this
sounds harsh, but, listen to what you are asking. Also, I was denied too
for my PS and they said I too could get approved with a "rash",
maybe I am a RICHER person inside b/c I decided to self-pay instead of
being a FRAUD! Heather Open RNY 8-15-02 305/183/150
— heathercross
March 24, 2004
Mods, please remove this post and remind this poster not to abuse Q&A
— heathercross
March 24, 2004
First I don't think anyone should be judgeing anyone. Cindy had a question
and we should answer not be nasty.
— sarah C.
March 24, 2004
No, I think I have thew right to speak my mind and anyone who is willing to
help her DEFRAUD an ins company should be just as ashamed. Its people like
this who ruin other obese people's opportunities to have Gastric Bypass!
— heathercross
March 24, 2004
Hello. This is not an answer to the post or even a comment about the
question asked. It is simply 'info' about the rash. I too have a large
apron and in the summer I am miserable. I go thru boxes and boxes of
cornstarch to try and stay dry under my apron. The rash is very painful. It
turns bright red and (sorry for this) slimy!! It actually feels as if the
skin is melting where it folds over. Not to mention the fact that it smells
bad. I'm sorry that you are having trouble wih insurance, but be thankful
that you DON'T have a rash. We all think of strange things when we are
desperate....I've not had surgery yet, no insurance, and have actually
fantisized about falling down in Walmart to get the cash....desperation is
an awful thing. But it was only a fantasy, I would never do such a
thing...I hope you won't give in either. God Bless You!
— Alisa Sheets
March 24, 2004
While I wouldn't condone trying to fraud your insurance company, I'm not
going to be mean about it. We all get desperate and the poster probably
wasn't thinking through all of the consequences, rather "What would it
take to be approved?" Remember guys, we're here to support...
— Ginger F.
March 24, 2004
Original post here. I am amazed at the horrified responses I am getting.
But it is nice that I have found a group of such perfect people that never
say things the wrong way and are 100% in everthing they do in life. Have a
great day and find some other person to save from themselves.
— blank first name B.
March 24, 2004
Cindy,
I am sorry that you didn't get the support you deserve, I know that other
people have thought of the same things. Some people ask how they can gain
weight to have the surgery, to me that shows how desperate they are. I
hope you can get your skin removal, they will usually pay for it if you
have a hernia as that does need repaired.
Take Care!
— Saxbyd
March 24, 2004
Cindy, I have the same problem as you. I could not develope a rash to save
my neck. Tried not cleaning throughly, tried splashing lotion and powder -
nothing. I finally got the medical guidelines from the insurance and they
also except medical documentation of LOWER BACK PAIN. The guideline was to
see a specialist in the field to document that the pannus caused or
aggrivated the back. I went to a Physatrist(orthopedical doctor but not a
surgeon. He said he would throughly support me in my effort to get the TT.
I am now waiting to hear from the insurance company. Good luck
— bbjnay
March 25, 2004
Oh please! As many games as the insurance companies play and as many hoops
that they make people jump through I don't see how anyone can feel sorry
for them.If the insurance companies wouldn't make it dang near impossible
to get approved for weightloss surgery and then plastics then maybe people
wouldn't have to resort to extreme measures like giving themselves a
rash.This is a common occurance and there are examples of it all the time
on this site.People tweaking their medical records,exaggerating their
weight related symptoms,lying about how many diets they've been on and yes
putting Nair on their skin to get a rash.It might not be a choice that
I would personally make but I'm not in the posters shoes so who am I or any
of you to judge.
— jennifer A.
March 25, 2004
I'm not horrified.. but you should know that defrauding the insurance
company could get you into a lot of trouble, the very least of which might
be losing your insurance all together and not being able to get any... so..
its just a thought. I certainly can sympathize with your plight though.
I'm not sure about the answer but I'd CALL cigna and find out the exact
parameters for approval and go from there. Good luck.
— Lisa C.
March 28, 2004
Heather Cross - "Stop the Hating" - We should be HELPING HER, not
climbing down her throat. I TOTALLY agree with everything Jennifer M said.
Also not everyone has the cash to spend on NEEDED reconstructive surgery.
Possibly they have OTHER bills.
Spring is coming on and poison ivy will be in season soon. If people
weren't desperate, they wouldn't be on here asking for advice and help.
Even if we don't ALL agree, she asked for help, not a lecture.
— bufordslipstick
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