Should I see PC to document skin issues?

Brandy~ · July 1, 2008

I have went through many posts and I do not see this as a subject.

This might sound like I am scheming.. So I guess in a way I am. I call it planning ahead hehe.

So far I have had really good luck with my insurance.. So my question is.. Even though I am only 30% of the way into my weight loss should I be going to see the doctor just so I have documentation of issues excess skin causes?

So I ride my bike about 13 miles a day and sometimes if I do not wear something to protect the extra skin on the lower stomach I get a rash from it rubbing... This also happens when I jog/walk fast.

Has anyone experienced being turned down because they couldn't document it or have they been approved because they did?

juliegeraci · July 1, 2008

My insurance didn't cover PS but if I were you I would go to either a PS if covered to take pics or your regular MD to track.

nip50 · July 1, 2008

My insurance will cover it if it is medically necessary. Some of their requirements are documented treatments of rashes for 90 days, 18 months post op, and a bmi under 30. I tried getting it done this summer but I'm only 8 months post op so my pcp will continue documentation of my rashes and I'll try again next spring and have it done next summer. I need it in the summer since I work in a school system.

Brandy~ · July 1, 2008

My insurance will cover it if it is medically necessary. Some of their requirements are documented treatments of rashes for 90 days, 18 months post op, and a bmi under 30. I tried getting it done this summer but I'm only 8 months post op so my pcp will continue documentation of my rashes and I'll try again next spring and have it done next summer. I need it in the summer since I work in a school system.

How do you document them? Do you go to the doctor each time? Take pics? or journal?

Sorry for all the questions but it could save me a ton in the long run.

nip50 · July 1, 2008

I already have to go to the doctor monthly due to taking coumadin so he just documents it everytime I'm there. He also has documented the different perscriptions that I've used for it and that it always comes back. With my doctor doing this, I'll have a full year of documentation by the time next spring comes.

If you don't regularly go to the doctor I would wait until just a few months prior to getting approval and see your pcp. You also need to make sure that he documents it.

Oh, one other thing my insurance wanted was documentation showing that my weight loss had been stable for at least 3 months. I didn't meet this guideline because I still want to loose another 20 pounds or so.

ousooner · July 1, 2008

YES, YES, and YES!!! LOL

like its been said, insurance needs documented proof that you are having skin issue in order to approve. Unfortunately, I had very few skin issues and was denied by insurance. If you can get your PC to document all you issues, you will have a better chance. Best of luck.

Brandy~ · July 1, 2008

Thanks for all the responses. I don't see a PC on a regular basis but I guess I might start now. It's $20 each time which is nothing compared to plastic surgery for sure. I was thinking I would go in atleast once and see her for it and then call back whenever it reoccurs and ask them to document the reoccurance :lol:

ousooner · July 1, 2008

Thanks for all the responses. I don't see a PC on a regular basis but I guess I might start now. It's $20 each time which is nothing compared to plastic surgery for sure. I was thinking I would go in atleast once and see her for it and then call back whenever it reoccurs and ask them to document the reoccurance

Yes, $20 per visit is much cheaper that the $10,000 I had to shell out :lol: Also, take pics anytime you have a skin irritation or rash. That helps too.

chocolate_snaps · July 1, 2008

Yes, $20 per visit is much cheaper that the $10,000 I had to shell out Also, take pics anytime you have a skin irritation or rash. That helps too.

Neal that certainly puts it into perspective! I guess I better start putting the screws to my PCP. I was wondering the same things Brandy.

Edited July 1, 2008 by chocolate_snaps

kareyquilts · July 6, 2008

I definetly would go to the doc and get it documented. I don't think you need to go to a plastic surgeon for that , however. I would go to your primary care giver or even your lapband doc, if they will help you with this. Good luck!

catseye · July 7, 2008

So I'm curious. I was just banded a few weeks ago, but I've had skin issues under my belly for years off and on-- a weepy, itchy, rash.

How many of you had issues before weightloss and still had them later? How many had it resolved?

pandagirl · July 18, 2008

So I'm curious. I was just banded a few weeks ago, but I've had skin issues under my belly for years off and on-- a weepy, itchy, rash.
How many of you had issues before weightloss and still had them later? How many had it resolved?

I have this issue, too. (Pre-op still so can't answer your question as intended.) My Dr. told that I should start getting these issues documented now so that I will have a stronger case when it comes time for PS. Has your's made any such recomendations?