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Thread: Yay for New...

  1. #1

    Default Yay for New...

    Ta Ta's!!

    As some of you know I had to have breast surgery last year. Luckily, we caught it early and I didn't have to have radiation or chemo. (I had Melanoma a few years back so I'm extremely diligent about my exams and tests since Melanoma is one of the deadliest forms of cancer.)

    Unfortunately, they took out a lot of breast tissue and I was left quite deformed after the surgery. I have an HMO so good luck having them pay for any kind of plastic surgery. (If it was a mastectomy, by law they would have had to pay for reconstruction.)

    I spoke with my physician and he submitted for a consult with a plastic surgeon and it was approved. I was sent to a hoyte-toyte Newport Beach Plastic surgeon that said my insurance would only pay for my "good" breast to be reduced to "match" the post-surgical breast. I had to ask several times to at least submit to reconstruct the post-surgical breast as well.

    "They won't pay" I heard several times from the front office girl.

    "Just submit and see what happens, please."

    "I do this all the time. They won't pay."

    "Please, let's just try. I've been with them for 24 years, they've never denied me any service, and my physician is the director of the group."

    "That doesn't matter. They won't pay."

    This literally went on for several minutes until she finally agreed to submit it to my insurance company.



    I got a call Friday. My insurance approved everything!!!!!!!!!!!!!! The girl could not believe it!


    Yay for new Ta Ta's!!!!!
    Last edited by Bunny; 08-04-2014 at 12:15 PM.
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  2. #2
    Pin Crusher Jaescrub's Avatar
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    Nice to see Dr. And insurance doing the right thing. We pay and pay out the nose and when we need so thing done to better our life or make us feel better "it's been proven the better you feel the better you over all health" they don't want to give out the Geat!

  3. #3
    High Roller vdubtx's Avatar
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    Woohoo!! Congrats Bunny!
    Way to be persistent with the medical office. Sometimes, they just don't like going the extra steps for the patients.

    Demand pics once you are all healed up. HAHA!
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  4. #4

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    Quote Originally Posted by vdubtx View Post
    Woohoo!! Congrats Bunny!
    Way to be persistent with the medical office. Sometimes, they just don't like going the extra steps for the patients.

    Demand pics once you are all healed up. HAHA!
    Lol!!! Hubby is happy to help with rehab!!

    Thanks Jae and Tx!!
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  5. #5

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    Glad to hear insurance came through for you! A lot of times it is very stressful and never ends well but hearing stories like this give me hope for the future of insurance.

  6. #6
    Bowling God Aslan's Avatar
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    I think they only will 100% for A-cups. You have to pay out of pocket for each size up from that.

  7. #7
    Ringer
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    Great news Bunny, and MOST importantly so glad they were able to catch it early.

  8. #8

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    Quote Originally Posted by zdawg View Post
    Great news Bunny, and MOST importantly so glad they were able to catch it early.
    Thanks All!

    Zdawg-Yes! Thanks!!
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  9. #9
    Bowling God Aslan's Avatar
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    I don't know if I can talk about this anymore. Maybe it's cuz I'm the only one that has actually met her...but talking about "those" is making me uncomfortable.

    Pretty soon they'll be talk about cycles and infections and "yeast" (in a non-beer way) and....yeah. It's like when you click through the channels and find a sort of cool sounding movie on Lifetime...but then every commercial they're advertising things that make me go, "Awwww....geez, come on man! Thats not right." I mean, after an hour and a half I'm trying to do the math in my head regarding how much liquid each maxi pad claims it can hold and how much is normal to come out and it just makes me not wanna eat or drink anything for a couple hours.

    And the worst is that chick from Halloween...and the damn Activia commercials....I mean for crying out loud! If I have to hear about her irritable bowels one mroe time.... Or the most recent thing to make squirm and leave the room...the old person commercial for mail order catheters. Seriously? I do NOT need to hear about the ease of insertion of catheters and how often to replace them...I am NOT ready for that.

    Oh...and P.S....Sheryl Crowe...can you lay off the beaten abused animals commercials for a little while!! I get it...some people suck. But man...it is really, really hard to get a good buzz on and watch National Lampoons Christmas Vacation when every 12 minutes your depressing *** shows up alongside a picture of a half beaten puppy. It's like watching tv at Guantonomo Bay!! Stop torchering me!!!

    Okay...sorry...what were we talking about. Oh yeah. PM me when the pics are up.

  10. #10
    High Roller rv driver's Avatar
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    Quote Originally Posted by Bunny View Post
    Ta Ta's!!

    As some of you know I had to have breast surgery last year. Luckily, we caught it early and I didn't have to have radiation or chemo. (I had Melanoma a few years back so I'm extremely diligent about my exams and tests since Melanoma is one of the deadliest forms of cancer.)

    Unfortunately, they took out a lot of breast tissue and I was left quite deformed after the surgery. I have an HMO so good luck having them pay for any kind of plastic surgery. (If it was a mastectomy, by law they would have had to pay for reconstruction.)

    I spoke with my physician and he submitted for a consult with a plastic surgeon and it was approved. I was sent to a hoyte-toyte Newport Beach Plastic surgeon that said my insurance would only pay for my "good" breast to be reduced to "match" the post-surgical breast. I had to ask several times to at least submit to reconstruct the post-surgical breast as well.

    "They won't pay" I heard several times from the front office girl.

    "Just submit and see what happens, please."

    "I do this all the time. They won't pay."

    "Please, let's just try. I've been with them for 24 years, they've never denied me any service, and my physician is the director of the group."

    "That doesn't matter. They won't pay."

    This literally went on for several minutes until she finally agreed to submit it to my insurance company.



    I got a call Friday. My insurance approved everything!!!!!!!!!!!!!! The girl could not believe it!


    Yay for new Ta Ta's!!!!!
    Good for you!! Perseverance pays. It's easy for someone to dismiss someone else's Tatas. If they'd been hers, she'd have filed in a New York minute.
    Breast cancer is no fun. I've lost two good friends to it, and know three survivors.

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