My OBGYN and another doctor both say I have severe Diastais and a herniated bellybutton. my abdominal aorta is wide open and can be easily felt with the docs hands. they tell me its dangerous and could be fatal if i accidentally get kicked or hit in the tummy or in a car wreck. it has to be fixed. how do you explain to your insurance company this is not a cosmetic proceedure and only an plastic surgeon can reconstruct the damage. i am not looking for a tummytuck at all. I just want the necessary basics done to fix my ab wall and cover and protect my aorta. i feel this is a necessary proceedure but do not have means to pay for all of it. how can i get my insurance company to understand this is necessary even after they receive a predetermination letter saying that it is necessary. Is there another kind of doctor that can fix my tummy other than a plastic surgeon? if so please let me know. my e mail address is misspookett@yahoo.com thanks hope to hear a reply asap
Answer:
Besides a letter from your doctor explaining exactly what your situation is, the only thing I can think of is if they could call your doc and speak to him directly.
Try asking your doctor if he knows of any other kind of surgeon that can preform the procedure.
I hope that it works out for you. Good luck. (will be crossing my fingers for you and sending positive vibes out for you).
A letter from your doctor is all you should need. You seemed to explain it to us pretty well, so if you have to explain it I am sure you will be able to convince them. Good luck!
Surely in this situation, your insurance co. will pay for it. If not, try other resources. Call DHS to see if they can help or at least steer you in the right direction, another is to contact the churches in the area(if you attend a church talk to your minister).
Try talking to the insurance agent yourself to plead your case! The doctor's letter should really be all they need to convince them it is urgent!
Best of luck to you! You don't say how far along you are?
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