Follow Up Question - I'm curious as to what this says I need for a Breast Reduction? (photo)

Hello, I'm 18 years old and a month or 2 ago I was attempting to be approved for a breast reduction. I sadly was declined, but they said over the phone I had met everything except one of these? What are some things I can do, because I'm not to good at reading doctor talk? And id really like to try again in a few months. Get more information, just don't know what I need to do? Please let me know what you think.

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Doctor Answers 3

Bring this to your primary care doctor

You need to jump through some hoops.  Have your primary care doctor refer you for physical therapy and to specifically see the requirements for approval before they write the letter.

Breast Reduction Appeal

Insurance companies have different requirements for get per-authorization for surgery, such as documentation that you have tried physical therapy to alleviate your symptoms, special bras, analgesics, etc. Your surgeon should be able to help you with this, ask you surgeon to appeal your request, I have gotten several patients approved by appealing. Good luck!

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 63 reviews

Follow Up Question - I'm curious as to what this says I need for a Breast Reduction?

I am sorry to hear about the difficulty you have experienced; unfortunately, it has been more challenging obtaining insurance authorization for breast reduction procedures. Persistence is often necessary.

 Based on the literature you posted, the insurance company has provided your requesting plastic surgeon more information as to their reasons for "denial". Best to follow up with him/her for specific information and advice. Best wishes for authorization and an outcome that you will be pleased with long-term.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.