Question:
I need help developing a rash for TT approval with hernia repair.

I have a huge hernia and a large apron. I have lower back pain but no rashes. Cigna is my insurance company and I was told that a rash sure helps with approval. Any suggestions? Thanks for your help!    — blank first name B. (posted on March 23, 2004)

March 23, 2004
Purposely "developing" a rash for insurance purposes is insurance fraud.
   — Jim F

March 23, 2004
Sorry, but, it's not the best idea to ask for suggestions to defraud your insurance company on a public forum, now, is it? If you don't have chronic rashes, then guess what, causing one isn't going to make any difference. The rashes/infections of the skin they are looking for are a cronic problem that can not be solved with the use of conservative measures, such as a perscription antibiotic. You can't FAKE those.
   — LMCLILLY

March 23, 2004
Not only is it insurance fraud, but it's disturbing that you would give yourself a rash just to get approval for a tummy tuck. I thought we were trying to make ourselves better, not worse.........
   — ScottieB86

March 23, 2004
I have to agree with above posters, besides being dishonest it may not serve you at all healthwise. You will be compromising your healthy skin and may open yourself up to healing issues post op. If you have a hernia and that may be covered by your insurance, discuss a self pay situation with your surgeon for the TT during the same operation. Good luck, Jackie O.
   — Jackie O.

March 23, 2004
I think that perhaps you were inquiring as to whether or not you could be approved for the surgery without a rash and asking for helpful suggestions as to how to best present your need for the surgery to CIGNA. Right? Your best bet may be to ask your surgeon to engage in a peer-to-peer review with a CIGNA doctor to explain the medical reasons for your panni removal-- given the size of your hernia, your development of lower back pain and the likelihood of developing serious skin infections, your surgeon could convince the insurance company.
   — SteveColarossi

March 24, 2004
Uh, this sounds like fraud missy! Do the right thing, save yourself some trouble down the road. :-(
   — aprilbaree

March 24, 2004
If you have a huge hernia they should cover at least that part of it, I agree if you don't have rashes count yourself lucky they are gross!!!!!!! And they are an infection and you don't want that.
   — Saxbyd

March 24, 2004
Cindy, YOU SHOULD BE ASAHMED OF YOURSELF....DEFRAUDING INSURANCE COMPANIES is ILLEGAL! If I knew your last name was real, I would report you to Cigna. GET A CLUE! Ins companies are now approving 50% less of RNY paitents everyday then they used to b/c of people like you. I know this sounds harsh, but, listen to what you are asking. Also, I was denied too for my PS and they said I too could get approved with a "rash", maybe I am a RICHER person inside b/c I decided to self-pay instead of being a FRAUD! Heather Open RNY 8-15-02 305/183/150
   — heathercross

March 24, 2004
Mods, please remove this post and remind this poster not to abuse Q&A
   — heathercross

March 24, 2004
First I don't think anyone should be judgeing anyone. Cindy had a question and we should answer not be nasty.
   — sarah C.

March 24, 2004
No, I think I have thew right to speak my mind and anyone who is willing to help her DEFRAUD an ins company should be just as ashamed. Its people like this who ruin other obese people's opportunities to have Gastric Bypass!
   — heathercross

March 24, 2004
Hello. This is not an answer to the post or even a comment about the question asked. It is simply 'info' about the rash. I too have a large apron and in the summer I am miserable. I go thru boxes and boxes of cornstarch to try and stay dry under my apron. The rash is very painful. It turns bright red and (sorry for this) slimy!! It actually feels as if the skin is melting where it folds over. Not to mention the fact that it smells bad. I'm sorry that you are having trouble wih insurance, but be thankful that you DON'T have a rash. We all think of strange things when we are desperate....I've not had surgery yet, no insurance, and have actually fantisized about falling down in Walmart to get the cash....desperation is an awful thing. But it was only a fantasy, I would never do such a thing...I hope you won't give in either. God Bless You!
   — Alisa Sheets

March 24, 2004
While I wouldn't condone trying to fraud your insurance company, I'm not going to be mean about it. We all get desperate and the poster probably wasn't thinking through all of the consequences, rather "What would it take to be approved?" Remember guys, we're here to support...
   — Ginger F.

March 24, 2004
Original post here. I am amazed at the horrified responses I am getting. But it is nice that I have found a group of such perfect people that never say things the wrong way and are 100% in everthing they do in life. Have a great day and find some other person to save from themselves.
   — blank first name B.

March 24, 2004
Cindy, I am sorry that you didn't get the support you deserve, I know that other people have thought of the same things. Some people ask how they can gain weight to have the surgery, to me that shows how desperate they are. I hope you can get your skin removal, they will usually pay for it if you have a hernia as that does need repaired. Take Care!
   — Saxbyd

March 24, 2004
Cindy, I have the same problem as you. I could not develope a rash to save my neck. Tried not cleaning throughly, tried splashing lotion and powder - nothing. I finally got the medical guidelines from the insurance and they also except medical documentation of LOWER BACK PAIN. The guideline was to see a specialist in the field to document that the pannus caused or aggrivated the back. I went to a Physatrist(orthopedical doctor but not a surgeon. He said he would throughly support me in my effort to get the TT. I am now waiting to hear from the insurance company. Good luck
   — bbjnay

March 25, 2004
Oh please! As many games as the insurance companies play and as many hoops that they make people jump through I don't see how anyone can feel sorry for them.If the insurance companies wouldn't make it dang near impossible to get approved for weightloss surgery and then plastics then maybe people wouldn't have to resort to extreme measures like giving themselves a rash.This is a common occurance and there are examples of it all the time on this site.People tweaking their medical records,exaggerating their weight related symptoms,lying about how many diets they've been on and yes putting Nair on their skin to get a rash.It might not be a choice that I would personally make but I'm not in the posters shoes so who am I or any of you to judge.
   — jennifer A.

March 25, 2004
I'm not horrified.. but you should know that defrauding the insurance company could get you into a lot of trouble, the very least of which might be losing your insurance all together and not being able to get any... so.. its just a thought. I certainly can sympathize with your plight though. I'm not sure about the answer but I'd CALL cigna and find out the exact parameters for approval and go from there. Good luck.
   — Lisa C.

March 28, 2004
Heather Cross - "Stop the Hating" - We should be HELPING HER, not climbing down her throat. I TOTALLY agree with everything Jennifer M said. Also not everyone has the cash to spend on NEEDED reconstructive surgery. Possibly they have OTHER bills. Spring is coming on and poison ivy will be in season soon. If people weren't desperate, they wouldn't be on here asking for advice and help. Even if we don't ALL agree, she asked for help, not a lecture.
   — bufordslipstick

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