Lipedema Insurance coverage for lipedema surgery has become more attainable recently. Prior to then, insurance was usually denied because it was considered a cosmetic procedure.

• Conditions or symptoms are present in all the following:
  • Pain in affected areas
  • Bruise easily
  • Weight loss efforts do not show any improvement in affected areas
  • Swelling in limbs
• In-person medical examination by Dr. Byrd to confirm evidence of the disease. Photographs must be submitted along with the findings. All the following must be submitted:
  • Bilateral symmetric adiposity (fat accumulation) in the affected extremities
  • Tenderness and nodularity of fat deposits in lipedema affected areas, such as dimpled or orange peel texture.
  • Non-pitting edema
  •  Negative Stemmer sign. To do a Stemmer test, try to pinch and lift a skinfold at the base of the second toe or middle finger. If you can pinch and lift the skin, Stemmer’s test is negative.
• Physical function impairment involving the ability to walk or perform activities of daily living.
• Individual must respond to at least three consecutive months of medical management. You must document the conservative measures you took during this period, showing that you have not responded to the medical management.
• File for pre-authorization before you have surgery.

The First Step In Becoming Qualified for Lipedema Insurance Coverage

The first step is to have an in-person evaluation, so we can prepare your documentation for pre certification. While we are out of network with insurance, if your pre-certification is approved, we will seek a gap exception for you so that your coverage will be considered at an in-network rate.  If your pre-certification is denied, we will also assist you through the appeal process and participate in a peer- to- peer interview if required.  Don’t let the insurance process discourage you.  We are here every step of the way to do whatever we can to try to get your procedures covered.

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Prosper Healthcare Lending is the premier financing company in the healthcare industry. With over $4 Billion borrowed and over 250,000 people empowered, this is a name and a program you can trust.

Here are some of the benefits you’ll receive with a loan from Prosper Healthcare Lending:

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We have worked hard to create a warm, inviting office environment, where you will feel comfortable and relaxed throughout any surgical or aesthetic procedure. If you would like additional information about products or procedures performed at Lipedema Surgery Center, please contact us at 866/671-5633 to schedule a consultation with Dr. Byrd.