NPSDEB
Networker
Our surgeons are starting to do Mastopexy surgeries before Mastectomy for breast cancer patients. This is to improve the outcome and to reduce the risk of complications. We have tried to PA this procedure, but most insurance companies respond with no PA required. We are using the cancer diagnosis or the genetic susceptibility when we submit for PA but they will not do the PA. Is anyone else doing this and what are you doing to ensure payment? Is there a workaround to get the PA. BCBS won't even look at them, they just auto cancel the request. Ucare has been denying them. Any input is appreciated.