I am concerned about the documentation that I dont have. I only have documentation of one appointment in the past where I've complained about my shoulders aching. I know that each insurance has requirements of what is needed to cover a reduction, however do they make exceptions? Doctors, are there many patients that get approved without the evidence of going through physical therapy? Patients, has anyone gotten their surgery approved without the doccumentation of going through physical therapy?
Answer: Breast reduction coverage by inusurance Hello and thanks for your question.Whether you tried physical therapy probably won't be a major factor in obtaining authorization.Pre-authorization requirements significantly are different significantly when comparing different insurance companies. Please visit a good board certified plastic surgeon with good reputation. Typically photographs are needed to be taken and sent along with a letter indicating your symptoms.Best wishes,Dr Sajjadian
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Answer: Breast reduction coverage by inusurance Hello and thanks for your question.Whether you tried physical therapy probably won't be a major factor in obtaining authorization.Pre-authorization requirements significantly are different significantly when comparing different insurance companies. Please visit a good board certified plastic surgeon with good reputation. Typically photographs are needed to be taken and sent along with a letter indicating your symptoms.Best wishes,Dr Sajjadian
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April 11, 2016
Answer: Breast reduction authroization Preauthorization requirements really vary quite a bit between insurance companies. I recommend you consult with a plastic surgeon who can start the authroization process for you which would require photos and documentation of your symptoms. Whether you tried physical therapy probably won't be a major factor in obtaining authorization.
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April 11, 2016
Answer: Breast reduction authroization Preauthorization requirements really vary quite a bit between insurance companies. I recommend you consult with a plastic surgeon who can start the authroization process for you which would require photos and documentation of your symptoms. Whether you tried physical therapy probably won't be a major factor in obtaining authorization.
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April 10, 2016
Answer: Insurance Cover Breast Reduction Without Physical Therapy? It will depend on your insurance company, most have several requirements and maybe not all need to be met, but you will have to check with your insurance company. Try to get whatever else you can to show what you have done to alleviate your symptoms, such as: letter from your general physician recommending a reduction for you, that you have tried taking analgesics, you have tried special bras. A letter from your physician and also from the Board Certified Plastic Surgeon may be enough, but again it will depend on your insurance company. Good luck!
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April 10, 2016
Answer: Insurance Cover Breast Reduction Without Physical Therapy? It will depend on your insurance company, most have several requirements and maybe not all need to be met, but you will have to check with your insurance company. Try to get whatever else you can to show what you have done to alleviate your symptoms, such as: letter from your general physician recommending a reduction for you, that you have tried taking analgesics, you have tried special bras. A letter from your physician and also from the Board Certified Plastic Surgeon may be enough, but again it will depend on your insurance company. Good luck!
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April 9, 2016
Answer: Can a Breast reduction be approved through insurance? Thank you for the question. Best to check directly with your insurance company to see whether breast reduction surgery is a “covered” benefit with your specific policy. Then, given that every insurance company has different “criteria”, best to identify exactly what your specific insurance company considers criteria for approval. Generally, the more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure. Also, for many insurance companies, the closer you are to your long-term ideal weight, the better.
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April 9, 2016
Answer: Can a Breast reduction be approved through insurance? Thank you for the question. Best to check directly with your insurance company to see whether breast reduction surgery is a “covered” benefit with your specific policy. Then, given that every insurance company has different “criteria”, best to identify exactly what your specific insurance company considers criteria for approval. Generally, the more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure. Also, for many insurance companies, the closer you are to your long-term ideal weight, the better.
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April 9, 2016
Answer: Insurance and BR Unfortunately, each insurance company has their own criteria. Large breasts (macromastia) or breast hypertrophy can occur in a variety of conditions (family trait, post pregnancy, excessive adolescent growth). In general when the excessive breast size causes functional problems, insurance will generally pay for the operation if more than 400 – 500 grams are removed from each breast dependent on your individual insurance company requirements. These problems may include neck pain, back or shoulder pain, hygiene difficulty, and breast pain. Other problems which are less likely to be covered by insurance include skin irritation, skeletal deformity, breathing problems, psychological/emotional problems, and interference with normal daily activities. Pre-authorization by the insurance company is required prior to surgery, and the process takes approximately one month. Each insurance policy has different guidelines and exclusions.This procedure is commonly covered by insurance through insurance criteria are becoming more and more restrictive.
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April 9, 2016
Answer: Insurance and BR Unfortunately, each insurance company has their own criteria. Large breasts (macromastia) or breast hypertrophy can occur in a variety of conditions (family trait, post pregnancy, excessive adolescent growth). In general when the excessive breast size causes functional problems, insurance will generally pay for the operation if more than 400 – 500 grams are removed from each breast dependent on your individual insurance company requirements. These problems may include neck pain, back or shoulder pain, hygiene difficulty, and breast pain. Other problems which are less likely to be covered by insurance include skin irritation, skeletal deformity, breathing problems, psychological/emotional problems, and interference with normal daily activities. Pre-authorization by the insurance company is required prior to surgery, and the process takes approximately one month. Each insurance policy has different guidelines and exclusions.This procedure is commonly covered by insurance through insurance criteria are becoming more and more restrictive.
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