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Associated Plastic Surgeons & Consultants Reports that Insurance Denied Payment for Bilateral Breast Reconstruction Following Mastectomy

Huntington, NY (PRWEB) March 26, 2013

A 50-year old woman underwent a bilateral mastectomy. A planned 3-stage surgical reconstruction was outlined by her plastic surgeon. The first two stages of the surgery went precisely as planned and was reimbursed by her insurance carrier.

Prior to the third and final stage (bilateral nipple reconstruction) her insurance carrier was appropriately notified. The surgery was performed and the patient did well.

Her insurance carrier ultimately denied paying for the final stage stating that the surgery was performed 2 weeks earlier than their arbitrary 3-month period between surgeries (not mentioned in their acknowledgment of notification). Currently, the patient is responsible for her entire bill.

The psychological trauma of a bilateral mastectomy was compounded by the fact that the insurance company, acknowledged her surgery in writing then ultimately denied payment stating that the surgery was performed too early. Is this acceptable when a woman seeks to be whole as soon as possible following a mutilating, life threatening cancer operation?

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