Incisional Hernia Repair, TAH, APPEN DECTOMY, LIPOATROPHY. MY I NSURANCE PAID FOR ALL THE ABOVE SUR.GIES. BUT, WHEN I SUBMITTED A REQUEST TO HAVE MY STOMACH AREA RECONSTRUCTED... BECAUSE OF AN WOUND INFECTION MY ABDOMEN RESEMBLES A GLUTES MAXIMUS I WAS DENIED REASON BEING MYY INSURANCE CARRIEER CONSIDERED MY RESQUEST TO BE OF A COMESTIC E NATURE.... OH VIOLENT ASSISTANCED ME WITH LOSS WAGES BUT COULD NOT OFFER ANY FURTHER ASSISTANCE. CAN YOU GIVE YOU GIVE ME ANY DIRECTION ? IM GOING CRAZY! I'M TRYING TO CONTINUE TO BE PRO-ACTIVE, I AM LOSING. PLEASE HELP ME REGARDING THE ABOVE?
First, I would talk to your doctor about the surgery and determine whether there are any clinical indications (physically or mentally) and then appeal the denial. Even if there are no clinical indications I would still appeal and submit your reasons for wanting the surgery in writing.
Then, I would call the hospital and speak with someone in patient accounting and explain your situation. Ask if they are willing to provide a discount on the cost since your insurance has denied it. If they can't/won't see if there is another hospital that can perform your surgery and provide you with the discount. Again, talk to your doctor who can give you the guidance on the hospital. If your doctor won't go to another hospital and you really want the surgery, you may have to find a new physician at a facility that is willing to work with you on the cost.
Any reconstructive surgery is subject to close review. However, if sufficient medical necessity can be documented the insurance company may cover your surgery. Complete and comprehensive documentation is the key.
I trust & believe there is an answer for me as relates to my wellness mental & physical. I didnt wake one morning and say... hummm I think I'll have my tummy tucked... my stomach surgery along with my comprimised immune cocktail placed me in a life threatening situation. I will reach-out to the eities you have suggested. God knows I truly appreciate your response, until the next time thank you so very much for being there.
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