Question:
NEEDED: Aetna HMO appeal for ABDOMINOPLASTY

Hi, I am in need of some advice on an appeal to Aetna for denial of the abdominoplasty procedure. My plastic surgeon is going to resubmit next week but I have to also prepare an appeal letter and don't know where to begin.... I have been treated several times for reoccuring rashes in the folds of skin at the belly button and at the hair line. I have about 12 pounds of skin to be removed due to a 140+ pound weight loss!! I have some lower back pain and I do sit hunched over alot... If someone out there has appealed the same procedure to Aetna and won abd would be willing to share you letter, I would be more than greatly appeciative!!! Thank you everyone and good luck to all out there! Renea..Neptune Beach, FL...322/180...size 30 now 12/14.    — reneagemini (posted on July 18, 2005)

July 18, 2005
The Abdominoplasty basically is skin removal, but also muscle tightening and sculpting, which is something that insurance companies frown on. The Panni is just skin removal... and nothing more. As far as they are concerned with the Panni and why you need it, it could have been caused by a tumor growth or something.... making them more apt to pay for this then an Abdominoplasty. You may want to save money up and just pay the difference if you want to have the abdominoplasty. Your Plastic Surgeon can try submitting the surgery as a Panni, but then do the math over that cost of the Panni for the Abdominoplasty.
   — Disneyfreak

July 19, 2005
Check out my website www.geocities.com/stephileeaz I have my appeal letter that won me my TT from Cigna! Good luck!
   — Stephanie B.