Medical Insurance paying for surgery

[Guest guest]

I also remember reading some time back ( I tried to find this post

but had no luck ) that one of you guys had your medical insurance pay

for your surgery by your Doctor submitting the procedure a certain

way.

Could you please re-post how this was done?

Regards,

MAL

[Guest guest]

My partner had his buffalo hump removed yesterday, with insurance

paying for it.

They initially denied the claim, and we appealed. We had already

submitted measurements and information on how it interfered with his

work functions (he's a schoolteacher and writing at the board was

difficult.)

Congratulations, Bob. Would it be too intrusive to ask which insurer? And it's not immediately self-evident how you would quantify the baseline and document the comparison. Videos? Establishing a norm with other non-HIV teachers? Are there OSHA standards for something like this? Anything that would be applicable to someone who no longer works?

Bob Emmitt

[Guest guest]

My partner had his buffalo hump removed yesterday, with insurance

paying for it.

They initially denied the claim, and we appealed. We had already

submitted measurements and information on how it interfered with his

work functions (he's a schoolteacher and writing at the board was

difficult.)

Congratulations, Bob. Would it be too intrusive to ask which insurer? And it's not immediately self-evident how you would quantify the baseline and document the comparison. Videos? Establishing a norm with other non-HIV teachers? Are there OSHA standards for something like this? Anything that would be applicable to someone who no longer works?

Bob Emmitt

I know of some people who have used the sleep apnea and neck pain route for reimbursement of hump liposuction. You may want to send an email to Dr Romano in San Francisco to ask him what he does. His web site (email is there) is

http://www.jromano.com/index.html

Vergel

Program for Wellness Restoration, PoWeR

An All Volunteer Non-Profit 501 © 3 Corporation

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[Guest guest]

Hi all,

My partner had his buffalo hump removed yesterday, with insurance

paying for it.

They initially denied the claim, and we appealed. We had already

submitted measurements and information on how it interfered with his

work functions (he's a schoolteacher and writing at the board was

difficult.)

We submitted more information about the " quantification " of impairment

of his range of motion, and it worked.

He's recovering well and very happy with the results!

Bob

>I also remember reading some time back ( I tried to find this post

>but had no luck ) that one of you guys had your medical insurance pay

>for your surgery by your Doctor submitting the procedure a certain

>way.

>Could you please re-post how this was done?

>Regards,

>MAL

>

>

>

[Guest guest]

>Congratulations, Bob. Would it be too intrusive to ask which insurer?

The local Blue Cross/Blue Shield

>And it's not immediately self-evident how you would quantify the baseline and

>document the comparison. Videos? Establishing a norm with other non-HIV

>teachers? Are there OSHA standards for something like this? Anything that

>would be applicable to someone who no longer works?

None of the above! There was no " baseline, " just measurements of the

estimated extent of the fatty deposit (length, width, depth above

" normal " slope of the neck).

Then we explained how it interfered with his work activities (writing

at the blackboard, difficulty raising his head because he had to push

against the hump.)

Then they asked for details on % decrease in range of motion. We

estimated normal range of motion. I told my doctor that I couldn't

really say he had *lost* any range of motion, but that we could

honestly say that his head motion was *impaired* through 50% of its

forward/backward range. Apparently that was enough to convince the

medical director.

Good luck to any/all trying to get the procedure covered!

Bob Munk

(Geez, there are a lot of Bobs on this list!)