Guest guest Posted March 4, 2003 Report Share Posted March 4, 2003 Does anyone have experience with UHC-EPO for the plastic surgery? What did they require for documentation? Anything they refused to cover and why? I will have lost about 170 pounds by surgery time. Boliver Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 4, 2003 Report Share Posted March 4, 2003 UHC-PPO has denied my first request for abdominotrunchoplasty. However, I am not giving up.. I am appealing the denial.. I will keep you posted on what happens. Hugs, from GA open RNY 12/12/00 Revision 04/18/01 Revision 02/07/02 St wt.... 392 Cw.......187 Wt loss..-205 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 4, 2003 Report Share Posted March 4, 2003 Dear , I have a letter from my internist that does document rashes, back pains, etc. I am hoping that the letter from my internist, my massage therapist and my own personal letter will convince them to approve my procedures so I can get on with my life. I am enclosing also the ASPS position paper on reconstructive plastic surgery after weight loss surgeries and some other ASPS documentation that supports that plastic surgery after weight loss surgery is medically necessary and reconstructive rather than cosmetic. hugs, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 4, 2003 Report Share Posted March 4, 2003 Holy cripes man - yows - what a loss - excellent job - deb in NE Life is not measured by the breaths we take, but by the moments that take our breath away... UHC-EPO coverage Does anyone have experience with UHC-EPO for the plastic surgery? What did they require for documentation? Anything they refused to cover and why? I will have lost about 170 pounds by surgery time. Boliver Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 4, 2003 Report Share Posted March 4, 2003 Boliver, if you get responses, please let me know as well. I have UHC-PPO. Hugs, UHC-EPO coverage Does anyone have experience with UHC-EPO for the plastic surgery? What did they require for documentation? Anything they refused to cover and why? I will have lost about 170 pounds by surgery time. Boliver Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 4, 2003 Report Share Posted March 4, 2003 , Did you and your doc document rashes and such? Just curious how much trouble they will give me. Hugs, Re: UHC-EPO coverage UHC-PPO has denied my first request for abdominotrunchoplasty. However, I am not giving up.. I am appealing the denial.. I will keep you posted on what happens. Hugs, from GA open RNY 12/12/00 Revision 04/18/01 Revision 02/07/02 St wt.... 392 Cw.......187 Wt loss..-205 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 4, 2003 Report Share Posted March 4, 2003 , Could you send me that ASPS document? Or tell me where to find it. Hugs, Re: UHC-EPO coverage Dear , I have a letter from my internist that does document rashes, back pains, etc. I am hoping that the letter from my internist, my massage therapist and my own personal letter will convince them to approve my procedures so I can get on with my life. I am enclosing also the ASPS position paper on reconstructive plastic surgery after weight loss surgeries and some other ASPS documentation that supports that plastic surgery after weight loss surgery is medically necessary and reconstructive rather than cosmetic. hugs, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 5, 2003 Report Share Posted March 5, 2003 I am not , but the papers she is refering to are in the files section of the OSSG-PlasticSurgery group. You can join that group and get them. I also have them if you want me to send them to you directly. Boliver > , > Could you send me that ASPS document? Or tell me where to find it. > Hugs, > Re: UHC-EPO coverage > > > Dear , > I have a letter from my internist that does document rashes, back pains, > etc. I am hoping that the letter from my internist, my massage therapist and > my own personal letter will convince them to approve my procedures so I can > get on with my life. I am enclosing also the ASPS position paper on > reconstructive plastic surgery after weight loss surgeries and some other > ASPS documentation that supports that plastic surgery after weight loss > surgery is medically necessary and reconstructive rather than cosmetic. > hugs, > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 5, 2003 Report Share Posted March 5, 2003 Dear , ::Big Hugs:: Keep fighting the good fight, Sis. I know 's appeal letter has helped a lot of people get approval! Take good care and you're in my prayers. Lots of love, Trace Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 5, 2003 Report Share Posted March 5, 2003 Thank you Sweetheart. sent me the link, and I joined that group last night after we talked. Hugs, Re: UHC-EPO coverage > > > Dear , > I have a letter from my internist that does document rashes, back pains, > etc. I am hoping that the letter from my internist, my massage therapist and > my own personal letter will convince them to approve my procedures so I can > get on with my life. I am enclosing also the ASPS position paper on > reconstructive plastic surgery after weight loss surgeries and some other > ASPS documentation that supports that plastic surgery after weight loss > surgery is medically necessary and reconstructive rather than cosmetic. > hugs, > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 5, 2003 Report Share Posted March 5, 2003 , I just got off the phone with UHC-EPO. There is not a statement in my policy that automatically denies coverage, so that is good news. The lady told me that they use a combination of tests to determine coverage. The first test is of course medical need. She told me to document rashes, infections, and any other thing that will help support this. The other test is functional need. She explained this as the skin flap hindering normal body function, as an example, due to my panni, I have to sit down to urinate instead of standing like most men do. (Sorry if that offends.) Otherwise I run the risk of wetting my skin or spraying all over the place. You do not have to pass both tests, but either one could be enough to pass. Of course I was talking to a phone person, not the person who will make the actual determination. It sound pretty good to me. Boliver > Boliver, if you get responses, please let me know as well. I have UHC-PPO. > Hugs, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 5, 2003 Report Share Posted March 5, 2003 WAHOOOOOO That is great news. I did the same with mine today, and got the same basic info. The key is to document. And to call your doc, get meds for the rash......... complain to your doc about issues, like my back, your having to sit......... that kind of thing. this is really good news. congratulations. Now just praying that all is as they say when we go for the actual approvals. Hugs, Re: UHC-EPO coverage , I just got off the phone with UHC-EPO. There is not a statement in my policy that automatically denies coverage, so that is good news. The lady told me that they use a combination of tests to determine coverage. The first test is of course medical need. She told me to document rashes, infections, and any other thing that will help support this. The other test is functional need. She explained this as the skin flap hindering normal body function, as an example, due to my panni, I have to sit down to urinate instead of standing like most men do. (Sorry if that offends.) Otherwise I run the risk of wetting my skin or spraying all over the place. You do not have to pass both tests, but either one could be enough to pass. Of course I was talking to a phone person, not the person who will make the actual determination. It sound pretty good to me. Boliver > Boliver, if you get responses, please let me know as well. I have UHC-PPO. > Hugs, Quote Link to comment Share on other sites More sharing options...
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