6 Critical Things You Need Before Submitting Your Preauthorization for Liposuction Surgery
Plus "how to" resources!
Hi L&M Community!
Like most everyone in the U.S., you’ve probably never had to ask your insurance company to pay for a medical procedure. And you shouldn’t be expected to do that; that’s typically the work between medical providers and your medical insurance.
If a doctor or hospital wants to get paid by insurance, they must show clinical evidence of why you need their service.
Although here’s a caveat: you are ultimately responsible for payment of medical services if the insurance cannot or will not pay. That’s why doctors give you that “I know I’m financially responsible” form to sign—so they can bill you if insurance doesn’t pay.
For example…
Your doctor wants to do elective knee replacement surgery for you. Well, you don’t just schedule surgery and get it done. Nope. First, the doctor must show you’ve gone through all of the steps of conservative medical treatment before he can get a pre-approval from insurance for knee surgery.
However, with Lipedema, the burden of getting approval for liposuction surgery is placed on the patient.
Maybe in a few years, this will be different. But right now, we—the patient—have to get preapproved for a surgery that is:
Typically considered cosmetic and not covered by insurance,
It is probably not even mentioned in your insurance benefits, and,
It is performed by plastic surgeons who don’t have a billing office set up for insurance approval because, historically, they have charged their patients for surgery.
All of this is quite a heavy burden to place on someone who does not know the medical insurance industry. In fact, it’s practically impossible. I mean, the stakes are high, and you’re going into a battle not knowing the rules or tricks of the trade. It would be like trying to represent yourself in a court case.
That’s where I come in. As a nurse case manager who’s worked in the medical industry for thirty years, fifteen of those years have been with medical insurance. I know how to navigate through insurance. And I want to show you how to do it too.