We will be happy to file your insurance claims for you, provided that you supply us with all required documentation and information.
Below we have listed insurance requirements that pertain specifically to breast reduction procedures. Please note that all of these requirements must be met for us to receive approval from your insurance company. We ask that you bring all required documentation with you to your initial consultation at our offices.
Insurance Requirements for Breast Reductions
The following insurance companies have certain requirements that must be met before they will give an approval for breast reduction surgery:
Blue Cross (out of state plans)
Their requirements are as follows:
A mammogram report within the last year.
AETNA requires that a woman 40 years of age or older supply a copy of a recent mammogram. (This usually means one performed within the last three months.)
Documentation that the member has seen their primary care doctor two or more times within one year with complaints of two or more of the following symptoms: headaches, upper back pain, neck pain and/or shoulder pain.
Documentation of treatments that were tried and failed. This would include any type of anti-inflammatory or other medications taken for the symptoms mentioned above.
Documentation that physical therapy or chiropractic care has been unresponsive to a three- to six-month course of treatment.
Please note that there may be other requirements for different insurance companies not listed above. Our office staff will be happy to help you with any questions you may have concerning this matter.