Panni Surgery Denied

[JustJo63 1]

I am two years out as of 1/11/18. I went through the process to be approved for a panniculectomy here in NY and BCBS denied me saying it is not medically necessary. I have rashes, smell and itching most of the time. It's embarrassing to be intimate with my husband and we've been together 35+ years. I'm depressed over this. Any advice on getting it approved? The surgeon I went to at Harlem Hospital was, in my opinion, very disinterested in doing my surgery. He did not send in photos or description of my issues. Any reference to a bariatric plastic surgeon would also be appreciated.

[Nagas1234 2]

Contact the surgeon who did your initial surgery and see who they refer. It's best to see a doctor who is familiar with people in this situation and knows what paperwork needs to be sent to insurance companies.

Sent from my SM-N950U using BariatricPal mobile app

[JustJo63 1]

The Surgeon I was referred to was from the Surgeon who did my surgery. Bellevue does not have plastic surgeons doing the surgeries for the bariatric patients any longer. that's why I'm trying get recommendations for other surgeons.

thank you for responding

[LELH 72]

I'm so sorry. Did you see you PCP for any of your issues due to extra skin? That should be fuel enough. Some insurances require the pannis to extend past the pubic bone. I would call and ask specifically why you were denied and what the requirements are, then get a new surgeon and dispute the ruling. Sorry I don't have any recommendations for your area. Hugs.

[JustJo63 1]

Thank you. I will try your suggestion