Hi - I am 4 weeks out from my bi lateral mastectomy and I was able to have immediate one-step reconstruction. Now I am getting information about the tattoo of the areola and nipples. I decided I did not want to go thru the surgery for nipples and would prefer to have them done at the same time as the areola as opposed to another surgery.
I have been told by my plastic surgeon as well as the person who does the work that the insurance companies generally don't pay for this procedure because the women's act has not been updated since 1998 and there is no provision for tattooing and they still consider it cosmetic.
I am appealing it thru my insurance company and writing to my state Department of insurance. I wanted to know if anybody has experience with this issue and can advise me of anything I should know to win my argument and get the insurance company to pay for this. It seems crazy that they are willing to pay 100% of a procedure that will be much more expensive as well as the expense of any potential complications and not pay for a much less costly and invasive procedure.
HELP!! Anybody can e-mail me directly at McAdamshi@msn.com
Thanks - Allyson
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FACECRAFTER
Joined: Jan 2009 Posts: 564 |
Nov 5, 2009 02:08 pm
FACECRAFTER wrote:
Tattooing should be covered by your insurance, as part of the reconstruction. If it is done by the same physician that did your recon, there is no choice. If it done by a tatto artist, it has to be someone who has been vetted by the insurance co. Or, like me, they person can do it at no charge, and then it is a no brainer...JUDY (Facecrafter) JUDY
Diagnosis: 8/18/2008, IDC, 2cm, Stage II, Grade 3, 5/20 nodes, ER+/PR-, HER2- |
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Double-or-N
Joined: Aug 2009 Posts: 25 |
Nov 5, 2009 02:57 pm
Double-or-Nothing wrote:
That is really nice that you do free tattooing for breast cancer patients. After reading Allyson's post, I checked my insurance claim for my tattoos and the claim is PENDING! I know the PS's office will take care of getting it paid for but, it is just annoying how the insurance tries to weasel out of paying. Diagnosis: 1/9/2009, DCIS, Stage 0, Grade 2, 0/3 nodes, ER+/PR+ |
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FACECRAFTER
Joined: Jan 2009 Posts: 564 |
Nov 6, 2009 12:52 am
FACECRAFTER wrote:
It's their job...Try not to take it too seriously. If you have a problem with insurance, ask for a case manager. One will get assigned to you, by the insurance co...and they really do help..JUDY JUDY
Diagnosis: 8/18/2008, IDC, 2cm, Stage II, Grade 3, 5/20 nodes, ER+/PR-, HER2- |
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renee-tatto
Joined: Sep 2008 Posts: 28 |
Nov 6, 2009 08:50 am
renee-tattoos wrote:
Judy...is there anyone is AZ doing the tattooing for free? www.ReneeMaschinot.com Cosmetic Tattoo Artist
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Amcadams48 Joined: Oct 2009 Posts: 14 |
Nov 6, 2009 10:49 am
Amcadams48 wrote:
Thaks for all your feedback...this is what I have found so far. In Tucson, where I live there is no PS that does the tattooing here. My PS referred me to a woman who does permanent makeup and restoration work. This is who he refers his patients to. She told me as well as my PS that the insurance stills considers this cosmetic and will not pay for it., The only way they will pay for it is if its done by a PS. The frustration is high because this has happened to many women in my PS practice. He had one patient who fought with the insurance company for over a year and he told me if anybody could have gotten it done she could have but to no avail. Evidently because the 1998 womens ACT has not been updated in 11 years there is no provision for this procedure. I was thinking about that. So many advances have been made in reconstruction in the past 5 years alone it makes sense to update this ACT, yet its never been done. Who would we have to get listning to get this going I wonder? However they will pay 100% if I have the surgery. Where is the logic? So frustrating to have to deal with this at the same time that we are dealing with so much else. Anyhoo I will wait till next year and if I have to pay out of pocket so be it. I am,working with the group who sold my company the insurance to see if we can file an appeal and see if we can do anything to get them to pay for it. If anybody does hear or know of a Tucson PS or free tattooing please pass on to me. Allie
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FACECRAFTER
Joined: Jan 2009 Posts: 564 |
Nov 6, 2009 11:06 am
FACECRAFTER wrote:
Amcadams: Please PM me the name of the person he sends you to. Tthanks. JUDY JUDY
Diagnosis: 8/18/2008, IDC, 2cm, Stage II, Grade 3, 5/20 nodes, ER+/PR-, HER2- |
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Makeupchick
Joined: Mar 2008 Posts: 160 |
Nov 7, 2009 09:28 am
MakeupchickNC wrote:
I have done hundreds of areola procedures (tats), spent a year doing all the paperwork to get insurance to cover...got an NPI number, filed all the forms and still have a folder an inch think of unpaid claims. They make it soooo hard on the person trying to get paid that we just give up after a while. Permanent Makeup Artists and tattoo artists are NOT in the medical field and therefore standard insurance rules do not apply, plus there are hundreds of insurance companies....who has the time to file all the pperwork, and refile and refile, after so many denials. There is no way they will make it easy on us EVER!!!! That is their job...... The docs may be paid a small amount if it is done in their office or by their nurse, but trust me even if you see them send a claim in for $1000 tat, they're not getting paid that either. <Many times it is considered part of the whole reconstruction and they cannot file a seperate claim for it. Every insurance coverage is different, even within the same company. This is why many of us in the industry such as myself, Judy and renee offer this service at no charge...so women can get quality work to finish such a long ordeal, without the headaches for any of us! Good luck ladies, I hope you can find someone to help you in your area, and thanks Judy for all the referrals you are finding for everyone... Earleen Bennett, Asheville Permanent Makeup Clinic
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ilovehorses
Joined: Jun 2009 Posts: 45 |
Nov 8, 2009 11:30 am
ilovehorses2 wrote:
Allyson, My PS said that I will have to pay for the Tat's then try to get my insurance to pay. He said they have paid some but it is hard. I'm also going to fight this too. I need to check for my benefits. I think they need to update this 1998 Act, tattooing is a big part of us completing our Reconstruction. My PS use to do them but he said this lady he referrers to now does a much better job. Good luck in Tucson, Di " When the Lords in Your Heart there's always two in the Saddle and you Never Ride alone".
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FACECRAFTER
Joined: Jan 2009 Posts: 564 |
Nov 8, 2009 11:49 am
FACECRAFTER wrote:
Di-- Who is the lady in Tucson? We need to know...JUDY JUDY
Diagnosis: 8/18/2008, IDC, 2cm, Stage II, Grade 3, 5/20 nodes, ER+/PR-, HER2- |
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Amcadams48 Joined: Oct 2009 Posts: 14 |
Nov 8, 2009 11:55 am
Amcadams48 wrote:
Her name is Elaine Pichets with "Artistic Touch, Inc." Allie
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Amcadams48 Joined: Oct 2009 Posts: 14 |
Nov 8, 2009 12:02 pm
Amcadams48 wrote:
I have decided to give up the aggravation of the fight with the insurance. I'm just going to wait until next April and then pay out of pocket for the tattooing. I do feel fortunate that I have health insurance that has paid for everything else and I have been thinking and I feel fortunate that I was able to have the one step procedure. Had I had the expanders I would still be waiting until next year anyway plus I have read on some of the posts that your implants could shift or drop so its better to wait months before the final stage. This is where I'm at now and if anybody hears of something new I all ears and who knows what will happen in the upcoming months. I am so happy that I am able to discuss these issues with others who are experiencing the same thing. This is so helpful and healing to just be able to talk to others. :) Allie
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FACECRAFTER
Joined: Jan 2009 Posts: 564 |
Nov 8, 2009 01:19 pm
FACECRAFTER wrote:
Elaine has been dioing Permanent Cosmetics for ten years, is certified (CPCP) and is an artist..good choice.. I am not sure how much she charges,,,You can also try Susan Alexander 520-270-6351 Thanks JUDY JUDY
Diagnosis: 8/18/2008, IDC, 2cm, Stage II, Grade 3, 5/20 nodes, ER+/PR-, HER2- |
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Nordy Joined: May 2009 Posts: 405 |
Nov 9, 2009 02:54 pm
Nordy wrote:
Facecrafter - do you know of anyone in the Portland area that tattoos areolas? thanks! Diagnosis: 4/21/2005, IDC, 3cm, Stage IIb, Grade 3, 0/12 nodes, ER-/PR-, HER2- |
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anniese Joined: Feb 2008 Posts: 99 |
Nov 9, 2009 04:58 pm
anniese wrote:
Judy - would be interested in hearing about someone in the Denver area that does areolas also. Thanks!! Diagnosis: 1/4/2008, IDC, 5cm, Stage IIIa, Grade 3, 0/3 nodes, ER+/PR-, HER2- |
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renee-tatto
Joined: Sep 2008 Posts: 28 |
Nov 9, 2009 10:02 pm
renee-tattoos wrote:
If you want to look up some cosmetic tattoo artists go to www.spcp.org and look up artists by state. You may need to call and see if they do areola repigmentation.... I am sure Judy will let you know if she knows of anyone. She is the best for putting together a list...Thanks Judy Renee www.ReneeMaschinot.com Cosmetic Tattoo Artist
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Nordy Joined: May 2009 Posts: 405 |
Nov 9, 2009 10:10 pm
Nordy wrote:
Thank you Renee - I found someone on that website that is local! I will ask my local PS if she uses her. That would save me one trip south to have it done! THANK YOU! Diagnosis: 4/21/2005, IDC, 3cm, Stage IIb, Grade 3, 0/12 nodes, ER-/PR-, HER2- |
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Amcadams48 Joined: Oct 2009 Posts: 14 |
Nov 10, 2009 10:59 am
Amcadams48 wrote:
Hi Judy - Thanks for Susan's name - I will absolutely give her a call as well. Allyson Allie
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FACECRAFTER
Joined: Jan 2009 Posts: 564 |
Nov 10, 2009 05:58 pm
FACECRAFTER wrote:
Please PM me for names. The reason I hesitate to post here is that I don't want to hurt anyone's feelings, or give the impression that I am endorsing anyone (although I am)..so a PM is in order. JUDY JUDY
Diagnosis: 8/18/2008, IDC, 2cm, Stage II, Grade 3, 5/20 nodes, ER+/PR-, HER2- |
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FACECRAFTER
Joined: Jan 2009 Posts: 564 |
Nov 10, 2009 06:18 pm
FACECRAFTER wrote:
Nordy- I wrote to you. Anniese, there are only 15 people in the entire state of colorado that are even members of SPCP never mind certified. write to me and I'll tell you where to start. JUDY JUDY
Diagnosis: 8/18/2008, IDC, 2cm, Stage II, Grade 3, 5/20 nodes, ER+/PR-, HER2- |
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anniese Joined: Feb 2008 Posts: 99 |
Nov 10, 2009 06:40 pm
anniese wrote:
Judy - I've pm'd you. Thanks. Diagnosis: 1/4/2008, IDC, 5cm, Stage IIIa, Grade 3, 0/3 nodes, ER+/PR-, HER2- |
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