Author Topic: had my surgery yesterday  (Read 5672 times)

Offline HellandBack

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Hi Art congrats and thanks for the info! I am confused and unsure of how to go about the approach to try and get coverage, if you can help me out with the steps you took and what to say to the Doctor so they try and help me out with getting it covered i would greatly appreciate it. I am getting desperate and willing to pay but if i can get it covered i would love it! Congrats again and let us know more of your recovery  ;D

Offline art

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Hi Art congrats and thanks for the info! I am confused and unsure of how to go about the approach to try and get coverage, if you can help me out with the steps you took and what to say to the Doctor so they try and help me out with getting it covered i would greatly appreciate it. I am getting desperate and willing to pay but if i can get it covered i would love it! Congrats again and let us know more of your recovery  ;D

My primary care doctor, as well as my plastic surgeon's office, took care of all the insurance issues, so I'm not sure exactly what they did.  When I received my paperwork from BCBS, the surgery was just labeled as "mastectomy."  I would call your doctor and ask them to help with the insurance, they've usually been around the block and will know what needs to be done for BCBS to cover you.

I will dig up my paperwork to see if there's anything else that could be of use to you.  If I find anything I'll post it.

Offline HellandBack

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Thanks Art, yes mastectomy is the removal of breasts usually for breast cancer, probably says that so it was not looked at as a cosmetic surgery thats why coverage is usually denied. I hope my stubborn doctors go to bat for me the way yours seemed to!  :D Did you just go to your primary doc and tell him you wanted surgery or you didn't like the way your chest looked or what? Sorry for all the questions i just want to know the route you took since that route worked! Thanx in advance

Offline art

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Thanks Art, yes mastectomy is the removal of breasts usually for breast cancer, probably says that so it was not looked at as a cosmetic surgery thats why coverage is usually denied. I hope my stubborn doctors go to bat for me the way yours seemed to!  :D Did you just go to your primary doc and tell him you wanted surgery or you didn't like the way your chest looked or what? Sorry for all the questions i just want to know the route you took since that route worked! Thanx in advance

I visited two local plastic surgeons on my own.  I wasn't very impressed with them.  When I saw my primary care doctor for a routine physical, I told him that I was looking at getting surgery to correct my gynecomastia.  He seemed to be very familiar with the condition, and he gave me the card of a plastic surgeon he's sent several of his patients to for it.  I did a consultation, and this PS seemed much more experienced with gyne surgery than the other two.  My primary care doctor got the ball rolling by submitting a written case for me, as well as hormone tests.  One of the stipulations with BCBS is that you must have normal, stable hormone levels.  The PS's office took over with dealing with the insurance after my consultation.  I think they needed to also submit some kind of written case for me.

Offline art

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johnsonx19, any luck with your insurance?


 

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