Diana's abdominoplasty/hernia repair insurance journey

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1) Still haven't heard back from surgeon (he's in surgery until this afternoon)
2) Ferritin came in at 111 - so I canceled the appointment with the hematologist, but told them I still wanted to register as a new patient, because I will need them eventually.
 
Finally spoke to the surgeon tonight (to be fair, he called last night, but I was on a long phone call with a friend, and the "No Caller ID" that came up is what another friend who is also a client, who tends to call me in the evening and mix business with casual conversation for a long time and then expect me to not charge him for any of it). They haven't heard back from the insurance company to clarify whether the plication will be approved upfront or not. So I'm still not on any schedule.

We also discussed lipo'ing the side ****age. I would of course have to pay for that. I'm not sure that it is worthwhile without skin excision to address the gross overflow that cannot be contained by a bra. Not sure I want to go through pain and expense if I'm not going to get much better cosmetic outcome. Part of the reason this matters is that if I DON'T have any cosmetic surgery, he can more easily schedule time at one hospital, which has outrageous charges for self-pay plastic surgery (OR, anesthesia); if I DO want the add-on lipo, he wants to do it at a different hospital, where he doesn't have time blocked out for him in advance, so scheduling might be more difficult.

I don't know what to do. But I'd better figure it out soon.

On a slightly different front, Charles has a long deferred surgery as well - the inguinal hernia he had re-repaired in 2014 has torn AGAIN; last year, he was told to hold out for as long as possible, because a third surgery has a much higher likelihood of leaving him in more pain rather than less :(. But he's in pain. So he decided that he would refuse to have surgery until AFTER I have mine - that was the standoff we arrived at last summer.

In the meantime, his surgeon who recommended watchful waiting left the practice, so he needs a new surgeon. So while I was on the phone with the surgeon, I asked him for a recommendation for this rather complicated procedure. He said he'd like to see the prior op report - which I happen to have right here in my electronic files - so I sent it to him. Won't Charles be surprised to find out when we go to the hospital and he meets the surgeon, that I'm lining him up for his own surgery, without telling him, for August, when we get back from our 2 month camping trip? Yeah, but that's what I have to do with him. He'll be PO'ed, and then he'll go along with it.
 
DAMMIT!! The codes for the plication were denied. Now there has to be an appeal, starting with a peer-to-peer between my surgeon and the insurance company’s medical director.
 
Is there a chance this will be more of a challenge, given that you are no longer in CA? (Not trying to make you grumpy. Grumpier.)
 
Yes, it would definitely be more difficult in AZ. I already won my case on the subject in CA in 2007 (but my insurance company refused to comply and that unleashed a whole regulatory review of all CA insurance companies, as well as class action suits against them). But I chickened out at the time.

But, not to worry - a phone call or two later, and the plication was approved today. I asked for the soonest surgery date, which means not getting side ****age lipo (the hospital where that would be done for a reasonable self-pay price isn't scheduling until May - no can do with our upcoming travels). I really don’t think a half-assed job of sucking out side and back fat without skin reduction is going to be worth the time and pain.

But I will get a four-fer out of it:
- Hernia repair
- Lipoma removed
- Abdominoplasty
- Muscle biopsy

The latter is to deal with a long term family issue. Years ago, my father had an episode of malignant hyperthermia during the removal of some lipomas on his back (i.e., not major surgery, but full anesthesia). MH is a genetic disorder. Since then, all of his kids, and my kids, have had to deal with the MH anesthesia protocol for surgeries, which is annoying. Not only do we not get the quickly reversible anesthesia drugs, so it takes a lot longer to wake up after surgery, but the OR has to be meticulously purged (takes 30+ min) of all of the verboten drugs/gases. The diagnosis requires a painful muscle biopsy. So may as well add it on here. If I don’t have the gene, my kids and I can drop the protocol. Doesn’t really help my siblings, because if Dad has it, I might not have inherited that gene, but they still might have. But we’re not putting 87 year old Dad through a muscle biopsy.

I should get my surgery date tomorrow.
 
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