Insurance approved TT!!!

babsyintx · March 23, 2005

Hi Everyone,

I know this should be under the plastic surgery section, but I wondered how many people look there? My insurance company called yesterday with a preauthorization for my abdominoplasty. The procedure code they gave me indicates that they will pay for the TT, but the lady who called me said the approval was for a panniculectomy. Either way, I am having the Tummy Tuck, but at least they are covering most of the cost (90%).

I have changed surgeons to another one in Fort Worth who is willing to do both the TT and a medial thigh lift at the same time. I dont really want to go under the knife more than once if I can avoid it. Apparently he works with another plastic surgeon and they work together concurrently on different body parts to cut the surgery time in half.

Also, the new guy isnt hard on the eyes and has been in practice since 1979, board certified and very active here in the community. I am meeting with him on the 29th of march and we can set a date. He's got a case study lapband patient on his website and in his ads in the magazines who he did a thigh lift, TT and arms. She looks pretty darn good, but she a lot younger than me and had less weight to lose. I am going to get everything done in June after I come back from vacation. I'll keep you updated!!!!

Babs in TX

334/180

-154

new goal: 170

Mariposa Bella · March 23, 2005

I am so excited for you, man, was it hard to get your insurance to cover this?? I am so truly excited for you, keep me posted, as I too will be getting a tt later this year, but I'll have to pay for it my self... So if anyone has any spare pennies send them my way...

Love,

Vera · March 23, 2005

Congratulations, You must be so trilled!

Take lots of pictures

Does this doctor have the stop smoking policy? How are you doing with that...

Alexandra · March 23, 2005

Wow, good for you, Babs! That's really exciting (and scary, I'll bet). I'd be very interested to hear what the medical reasons were that you used to get insurance to pay. I'm sure we all are!

babsyintx · March 23, 2005

Hi Girls,

My insurance company is Motorola PPO administered by Humana Choicecare. Shipps Health is the precertification/preauthorization arm for Motorola. They assign a case manager and a number and give the docs and photos to the medical director to review. Actually the approval was really easy. It was the surgeons office that made it difficult by sending it to the wrong place. All my insurance required was photos and a letter from the surgeon stating medical necessity. I personally did not think the letter was that impressive, but the previoius surgeon states that I have had problems with rashes, back pain, trouble exercising yadda yadda. I even offered support documentation from my PCP and OBgyn and the surgeon said that it was not necessary. So all they recieved was his letter and a couple of digital photos. I was looking at the ratings they have regarding abdominoplasty (they rate on a scale of 1 to 5)

1) panne hangs to above pubis with skin touching Bla bla

2) panne hangs mid pubis

3) panne hangs below pubis

4) I think mid thigh?

5) hangs to knee (cant imagine the horror of living like this)

I am a one based on this criteria, so certainly I am not the most serious case of excess skin out there. My doc says around 5 pounds of excess. Some thin women after babies have this much, so I guess I am not a horror case!

My thighs are worse in my opinion with a total of about 8 pounds of excess or more. The new surgeon wants me to quit smoking as well, but he is OK with 3 weeks prior and 4-6 weeks post. The other doc wanted me smoke free for at least two months. At the end of the day, it doesnt matter. Once I quit, it will be for good if I can make it that long.

Apparently medial thighplastys are harder to get an approval. I am sure that I meet the criteria for this, since I have a history of active skin infection in the mid to upper thigh.

I am glad that my hubby has good insurance. They paid 90% for my lapband as well and approved that in 24 hours as well. They even called me the same day within 24 hours of the time the documentation hit the medical directors desk. Cant ask for more than this!!!

Babs inTX

cadydid · March 23, 2005

That is great!! I'm looking to get a Tummy Tuck before the holidays but my insurance is probably not going to approve it.

I will call you when I arrive in Dallas. Looking forward to getting together with you!

doyle9032 · June 30, 2008

could you tell me your ps doc name i live in dallas i want to get a tummy lift after being banded 12-06 lost 70 pounds doc said i had about 13 pounds of ecess skin in belly that doesnt surprise me all was a big apple shape 246 my highiest almost 180 now goal ic 160 so i would be real close if i could get rid of yhis 13 pounds,my belly just hangs and there is no way ill ever be able to were bikinies panties or not even hi cuts because this fat just hangs out of it,and i do have to roll on deoroant up under it or i sweat and get a rash.