Disappointed with PS consult! (m)

iVillage Member
Registered: 03-26-2003
Disappointed with PS consult! (m)
10
Wed, 03-26-2003 - 10:46am
Well ladies, I had my first ps consult yesterday and I am very disappointed with it. The ps wouldn't even look me in the face while she was talking to me. I had printed out the plastic surgeon questions from this site and had highlighted the ones I was concerned with. Well she saw my list and said, "Go ahead and ask me your questions, but I've already answered them all a million times."...How rude...a million times maybe, but none of the people asking the questions before was ME!!! I was devistated when she said that!

She did take my pics and told me I could safely go down to a small to full C, since I am a DD or DDD. But when I asked her about the ins, right away she got loud and said I don't handle that and I know nothing about it, you'll have to speak to Belinda about it! Shouldn't a ps know something about how the ins co's work?..I would think so, atleast enough to inform HER patients! Belinda is not doing my surgery, she is! (well probably not now!)...

So as for the ins info. When I called to set up my consult over a whole month ago, they said to fill out their paperwork and bring in my referral from my pcp. So that's what I did. Both my obgyn and pcp referred me to have breast reduction surgery. The obgyn was oral and the pcp was written. Both are accepted by my ins co. But now they (ps office) are telling me I need letters from both my obgyn and pcp stating the reasons for having it done and why it's considered "medically neccesary."....She said they can't do the letter because they are the operating doctor. I don't understand that. From the others I've read on the board, the ps does the pre-determination letter. Am I right?...Has anyone else needed letters like this?...

So I am back to square one. Had they told me this a month ago I could have probably had the letters already. Since I'd already seen both of them prior! But now I have to wait even longer to get the letters. She said after she faxes everything to the ins co, it should take 2-4 weeks to find out, even though when I first called they told me 12-14 weeks!

All in all, I am sad at the way yesterday turned out. Luckily I got 2 referrals from my pcp and I am now seeking out the other ps. I have a consult with him April 15th! His office told me on the phone that all I should need is the written referral from my pcp. Both my pcp and the ps are friends, so that may help, they happen to be in the same bldg too! The new ps office took all my ins information and said they would contact them before hand to find out exactly everything I need to get and she would let me know. But I will also be calling them this afternoon to find out what I need to have done.

I have already called the obgyn and pcp to ask them to go ahead and write letters for me, just in case, and I figure it may help me out in the long run.

Belinda, the ins lady yesterday also told me that all ins co deny anyone who is more than 20% overweight. Has anyone heard this before? I know there are several others on this board about the same height/weight as me. 5-4 200lbs. I realize I'm overweight, but except for my chest, I carry it all in my lower half.

Since I have now written a book....lol...well anyways that's how my day went, I sure hope the next consult is better!!

Trish

iVillage Member
Registered: 03-31-2003
Sun, 03-30-2003 - 10:55am
Hi Trish...

I am so sorry to hear about all this. Getting the approval is definitely the most "gruesome" part of the entire BR. Really!

I strongly suggest that you dump this first PS and try the next one. And as for the letters from your docs, well.. they'll probubly be required anyway, so your may as well just get it going now. Good luck sweetie... I'll be praying that it all works out it, and it WILL, it'll just take a little time and whole lotta determination!

We're here for you! Take care, love Marley

iVillage Member
Registered: 03-26-2003
Sat, 03-29-2003 - 9:29pm
I just wanted to send a cyber "thanks" to everyone for all their support and advice!

I appreciate it all greatly!!

Wish me luck on the 15th!!!

iVillage Member
Registered: 03-28-2003
Fri, 03-28-2003 - 11:33am
Trish

I am so angry for you that your PS treated you that way. I would definitely be finding another PS, if she can't take the time to answer your questions and address your concerns on the consult visit, then I wouldn't want her. I can imagine how unsupportive she would be if there were complications healing.

As for insurance, all of the PS's that I saw handled the insurance right there in the office. My PS told me himself that my insurance is usually very easy to deal with, he seemed to know exactly what he needed to do and what he needed to send. She just sounds downright rude. As far as being overweight, I've never heard anyone say ALL insurance companies deny you if you are overweight. That's ridiculous. I am 5'1" and need to lose 30-40 lbs, but my PS just told me that it would be much easier after the BR. Hope your next consult goes better.

iVillage Member
Registered: 03-26-2003
Thu, 03-27-2003 - 3:41pm
YEP! I have heard of some ins co's wanting you to lose some weight so they can see if you are able to lose weight from your breast or not, but I had never heard anyone 20% overweight was automatically denied! And when I was looking thru her before/after pics I'd say 99% of the woman were bigger than me! Many of them had "rolls" and I don't have any. I carry my weight in my thighs, legs and bum. When I lift up my boobies I look slim in the middle.

Needless to say I won't be having her do my surgery. I just don't feel comfortable with her. She couldn't even look at me when she was talking to me! And that's one of my biggest pet-peeves...To me it comes across as dishonesty when someone can't look you in the eye while speaking to you.

Her work looked great but the attitude sucked! The new ps office was very nice to me on the phone and I'm looking forward to meeting with him! Wish me luck!



iVillage Member
Registered: 03-27-2003
Thu, 03-27-2003 - 3:21pm
That woman was wrong about the weight issue!! I am not sure who she thinks she is that she speaks for all insurance companies. I am 5'6 and weighed 230 when I had my reduction and there was NEVER any mention of me having to lose weight!!

As far as your first ps- run away from her as fast as you can. Advise other women to stay away from her as well.

iVillage Member
Registered: 03-26-2003
Thu, 03-27-2003 - 9:56am
Thanks so much for your support ladies! I appreciate it greatly. Now that I think about it Jill, she didn't even discuss how she would preform the surgery she only told me that she uses stitches instead of staples, but that was only an answer to my question.

I have decided that I will not go to her again. I have another consult on the 15th of April with another ps. His staff was very pleasant and told me that all I should need is the referral which I already have, but I went ahead and asked for letters from the obgyn and pcp just for further evidence of my medical necessity.

As for the weight issue I am currently doing Power 90 (beachbody.com)! I feel great so far and hope to accomplish my goal of losing the extra 40-50 lbs I carry around! And my surgery probably wouldn't be until late July-August cuz I have a busy summer planned already. So maybe I'll be fit by then!

This board is great! Much appreciation to everyone!

iVillage Member
Registered: 03-27-2003
Thu, 03-27-2003 - 8:45am
I agree with everyone else. Do not use this ps! Do you really want someone operating on you who treated you this way??? My ps answered any question I had, took time whenever I needed it and even called me at my office to answer my last minute questions the week before the surgery.

I'm sorry to say this but I would just start all over. Your insurance company should have other ps surgeons to choose from. Pick another one and go for another ps consult. Call the other ps's office and tell them you are not interested and do not forward anything to the insurance company.

Good luck to you!

Mellissa

iVillage Member
Registered: 03-26-2003
Wed, 03-26-2003 - 8:05pm
Do not go with this lady! She sounds horrible. I can't believe she would say that to you about your questions! I would not mess with her anymore. Hopefully this other PS will be better. My PS was wonderful. She took all the time I needed and she even complimented me on all my questions! She said she thought it was great I did my research before hand and even knew what questions to ask. Also, they handled the pre-determination letter. They suggested I get letters from my ob and my family doctor to send with theirs, just so we'd have more ammunition. I have heard of some ins. companies denying it based on weight, but that doesn't mean they all do! Unbelievable, I can't believe the way they treated you. I guess I had such a great experience with mine, it's amazing to me. Goodluck! Betsy
iVillage Member
Registered: 03-22-2003
Wed, 03-26-2003 - 6:40pm
Trish,

OMG.. What a horrible consult!! First of all, if there is any way you can do so - LOSE THE PS AND FIND ANOTHER! That doctor was utterly rude! And the entire thing is so completely contrary to what I experinced that I can't believe it!

I had a top PS and his staff was amazing! The consult with the doctor was a pleasure! He raved about the benefits of the surgery, answered every question I had with a smile. He put me TOTALLY at ease! The examination was brief but he explained what he was going to do, how much he anticipated removing and so on. The photos were taken by his assistant and then I came out and sat down with his office manager type who showed me the books with the before/after shots, gave me all the pre-op info, let me know what to expect from the approval process (and THEY submit everything and stay on top of it) and then we looked at tentative dates pending approval. It was all very pleasant and very professional.

The fact that you need written referrals may very well be a requirement of your insurance company and if so.. that's fine and a simple phone call at this point should handle that. But make sure that YOU get copies of those letters so that you have them wherever you end up going.

But you need to look into another PS because the attitude of the one you had was totally standoffish and I don't think that it makes for a comfortable relationship. While most surgeries run smoothly - there are times where problems occur and you have to know that you can call their office and get a sympathetic ear and good advice and not have anyone snapping your head off!!!

In addition.. I am not aware of the weight guideline. I was a good 30 pounds overweight when I had my surgery and that didn't appeat to be an issue at all in the process. My PS DID tell me that the weight issue is often a very personal choice for the PS and many don't like to do the surgery on a seriously overweight patient but his philosophy was that weight did not lessen the benefits of the surgery and that he had no issues with weight.

I don't know Trish.. I think you should get another PS and start the process over because this one does not inspire "confidence and comfort"!!!

Jill

iVillage Member
Registered: 03-26-2003
Wed, 03-26-2003 - 11:45am
I'm so sorry the appt went so poorly. She sounds like she has a bad bedside manner.

As for the letter of necessity from your pcp, my insurance requires the same. Basically, they need a letter stating that I have been under care for back and neck pain for several years and a list of treatments we have done.

I also have heard of people being told by ins co that they need to lose weight. I lost 40 lbs before seeing the ps for that reason.

My ps doesn't have the best bedside manner either but basically it's just because he doesn't have the personality. He is far from being rude, though. She sounds downright rude.

I wish you much more luck at the next appt.

Cherie