Another important thing is to be diligent. Insurance companies often have tactics to discourage you from seeking approval for procedures. Usually, the insurance company would prefer that you pay for reconstructive procedures yourself. So if you are initially denied: appeal, appeal, appeal. By law, the steps detailing how to appeal are listed on any letter that informs you of a denial. Take advantage of the information, and be prepared to submit an appeal in writing as necessary.

Although with insurance companies, written documentation is king. But don’t be afraid to also call the insurance company to try to find out what factors led to their decision. (That’s what I did after I was initially denied, once I found out who made the decision, I called more than once and asked if my entire file was sent. After some research, I had the file sent again to the doctor who acted as the clinical director and I was later approved. )

Once documentation is received by the insurance company you'd be surprised how often file documents are separated, lost or mislaid. So if the insurance company or a specific department of the company (like the Pre-Determination department, which often makes the decision for reconstructive surgeries) says they didn’t receive the photos along with your file - then ask your surgeon’s office send them again. If they don’t have copies of letters from your other doctors, be prepared to send those again as well. Make sure you are fully prepared with any documentation they would need to make their decision, and you are better assured of approval.

NOTES - I don't really know who to give credit for, but I found it while googling on someones blog, I couldn't find a name. But It is not mine - although this person was very informative and I appreciate her cander.:biggrin:

You are amazing!!!!!!!!!

Ah, thank you.