Question:
Has anybody had a total abdominal wall reconstruction?

3 yrs after bypass, 300 lbs lost, too many complications to list..Had hernia repair with tummy tuck and now have staph infections from mesh. Dr wants plastic surgeon to not use mesh but the component separation method of abdominal reconstruction. They use your own muscles to repair the hernia and prevent rej of mesh. No plastic surgeon in the ins network that my doctor works in. Am trying a out of network referrel..any suggestions, plastic surg want 9000 up front and i will only be reimbursed for the amt they would pay if under contract with him/or if they can find somebody else will need to go to their surgeon,infectious disease guy and plastic surgeon. i want my own docs..tired of antibiotics been on since last september and pain,puke and bathrooms.    — Louise W. (posted on July 8, 2005)


July 8, 2005
you do not have to stay in network for a medically aproved proceedure, the insurer will have to provide/accomodate your medical needs if medically neccesary and if a doctor out of network is necesary they will have to pay the price, that is what aetna is doing for my wls, as i cannot have a rny and they dont have a ds surgeon in net they are paying the out of net surgeon full price for the ds. and the ds is generally exluded too. they are required to cover network deficiency
   — walter A.




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