My insurance has approved codes 15830 and 15847.

My question is for anyone who knows about insurance. When the plastic surgeon called they said they wanted me to come in and go over my insurance benefits and discuss the "cosmetic" cost of the procedure. Are they going to try and sell me other things or are they going to try and tell me that there are things that are my cost that really shouldn't be? Insurance said they are covering both procedures and everything that goes along with them so what could I possible have to discuss cosmetically?

Any info would be greatly appreciated!

Here's what my insurance states:

Clinical Conditions

Reconstructive

Abdominoplasty

When the following conditions are met:

• Panniculus hangs to or below the level of the pubis; and causes chronic intertrigo that consistently reoccurs or remains refractory to appropriate medical therapy that includes systemic antibiotics, topical anti-infectives, anti-inflammatory medication and appropriate skin hygiene; OR
• Repair of diastasis recti in the presence of a true midline hernia (ventral or umbilical).

So I just went for a second opinion. UNREAL!! This guy charges 5grand for the TT WITH lipo. That's less than the other doc wanted to charge with insurance. They are going to submit a pre cert today to see what will be covered but I am going with him regardless.

1st doc- $10,000 for TT no lipo

$6,000 for TT with insurance paying part

2nd doc $5000 for TT with lipo (no insurance)

Waiting to see what amount insurance will cover.

I don't think I am going to find a better price and I am hoping if I can't afford the TT that he will give me a little freebie if I do the panni. Lol.

This guy is older, board certified, and patient choice award. I don't think he's in it for the money anymore like the younger doctor I saw first seems to be.

Please oh please let this work out!!

Maybe if he charges $5000 for the panni to the insurance company he will also do the muscles tightening while he is in there....He knows you have the approval for the other two procedures right? This PS sounds like your man. I believe you just know when it's right....Funny because my first time around, I just didn't feel right and I thought it was just nerves... I learned to listen to that voice inside of me. When I met my second PS I felt so at ease.... Now the new PS is having to redo some stuff from the first guy...(that is when I save up the money again)...ugh

So, just in case, some things to consider... Find out if you can see some of his work first hand, and check the internet for complaints. Is the anesthesia fee included, and what about the or, & hospital stay? One of my friends was given the bargain price of $5000.00, only to get additional bills from the facility and anesthesiologist, bring the price closer to 10 thousand.

Also, please take into consideration that these docs come out of school with huge education cost, malpractice insurance, and office start up, equipment and staff. It does not make them out for the money, or BAD people, their overhead is ridiculous. Just sayin' .

According to RealSelf the average price total for a Panni with out the muscle repair is $6,125 with prices I saw anywhere from 3-8 thousand...so the 5 you were quoted sounds just about right...You can go there and check out other reviews from his patients too..

Thanks for all of that! They have their own facility the surgeries are done in, which saves a lot on cost. I will be sure to get it all in writing so I don't encounter what your friend did. As far as the price, he has been in practice for like 35 years, so when I say he's not trying to make hand over fist, that's why. And honestly, if one doc gives me a price with my insurance that is more than another's price cash pay, I would say she is making bank. Whether it's bc of her insurance and education cost makes no difference to me. Experience and reputation will win me over.

So, just in case, some things to consider... Find out if you can see some of his work first hand, and check the internet for complaints. Is the anesthesia fee included, and what about the or, & hospital stay? One of my friends was given the bargain price of $5000.00, only to get additional bills from the facility and anesthesiologist, bring the price closer to 10 thousand.
Also, please take into consideration that these docs come out of school with huge education cost, malpractice insurance, and office start up, equipment and staff. It does not make them out for the money, or BAD people, their overhead is ridiculous. Just sayin' .

Thanks! I have been on there daily trying to look for more PS to get opinions from. I have another today and after this one I will see if I feel I need another opinion.

According to RealSelf the average price total for a Panni with out the muscle repair is $6,125 with prices I saw anywhere from 3-8 thousand...so the 5 you were quoted sounds just about right...You can go there and check out other reviews from his patients too..