Vascular Birthmarks Foundation Forum - View Single Post - Insurance coverage and surgeries
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Old 12-01-2011, 12:19 AM
nickbar nickbar is offline
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Join Date: Aug 2003
Location: Pacific Northwest
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These surgeries have been approved. It takes some work and dedication to get approval, but I do have some tips. It is important to have a surgeon that is willing to go that extra step to fight the insurance if needed. So, if denied as not medically necessary, you should receive a letter from the insurance co. with a peer to peer review phone number. Provide this number and a copy of the denial to the doctor asap. You doctor can talk directly to the medical director that denied the approval. Often this is enough for a doctor to explain why it is best to have the procedure now vs. later and why it is medically necessary. We really need to take the approach that this is not a cosmetic issue... it is a abnormall occuarance that appeared at birth or shortly after and you are seeking a return to normal or as close to as possible. Please feel free to email me if you need more details and Basia is a great resource if you ever need to appeal.
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