ffs surgeons who take insurance

These delicate procedures change the male facial patterns to a softer, feminine appearance. 3). For people without local connections, the facebook group, FFS Facial Feminization Surgery / Transgender TG TS and the FFS Forums on susans.org are good places to seek community support as well. A letter from your primary care provider or whoever prescribes your hormones. It is important to be aware of the side effects that will certainly occur, like swelling, bruising, and incisional scars. Copyright TransHealthCare.org & Trans Media Network, 2011-2022. . KP FFS Surgeons. Dr. Dulin offers transgender women the following surgical services: Breast Augmentation: Get the curves you desire. Most other insurance plans do not cover FFS and consider it as cosmetic surgery. The FFS Surgeons listed below are highly qualified plastic, cosmetic and maxillofacial Surgeons who regularly perform FFS. Top facial feminization surgeons will typically undertake 2-3 facial full feminization procedures a week, this equates to at least 100 or more a year. He currently performs approximately 200 genital reconstruction surgery cases per year in Scottsdale, Arizona and Portland, Oregon. information about insurance coverage: video.transcendlegal.org 2. Justine C. Lee, MD, PhD, FACS, University of California, Los Angeles, Division of Plastic and Reconstructive Surgery, 200 Medical Plaza, Suite 460, Los Angeles, CA 90095-6960, E-mail: [emailprotected]. Due to the gender non-discrimination laws of the state, the denial is typically overturned and the procedures are authorized. Plastic and Reconstructive Surgery - Global Open, Get new journal Tables of Contents sent right to your email inbox, Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), https://www.transequality.org/sites/default/files/docs/USTS-Full-Report-FINAL.PDF, https://blog.doximity.com/articles/doximity-2018-physician-compensation-report, PRSGO_9_5_2021_03_23_LEE_GOX-D-21-00105_SDC2.pdf; [PDF] (74 KB), Facial Feminization Surgery under Insurance: The University of California Los Angeles Experience, Articles in Google Scholar by Allison C. Hu, BA, Other articles in this journal by Allison C. Hu, BA, Factors Influencing the Choice of Plastic Surgery as a Specialty in Saudi Arabia, Outcomes of Implant Removal and Capsulectomy for Breast Implant Illness in 248 Patients, A Safe and Effective Lip Augmentation Method: The Step-by-Step (Phi) Technique, Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence. I can't guarantee that you'll achieve coverage, but depending on how your insurance benefits are regulated and the support resources you have access to, it's definitely worth trying. Hu, Allison C. BA*; Dang, Brian N. BS*; Bertrand, Anthony A. MD, MBA*; Jain, Nirbhay S. MD*; Chan, Candace H. BS*; Lee, Justine C. MD, PhD, FACS*,. The concept and treatments were developed with transfeminine patients in mind in the 1980s, led by a San Francisco-based surgeon who devised measurements for a "normal" female appearance by surveying anthropological skeletal records. Dr. Harris is a highly skilled, board-certified Surgeon in the Dallas area who has been developing an international reputation for transgender surgery. Qual Life Res. Insurance coverage for FFS is an important issue for a number of reasons for both patients and surgeons. Location: Bangkok, Thailand. Received for publication February 2, 2021; accepted February 27, 2021. Surgical techniques and analysis of results. Schedule surgery As with any surgical procedure, there are risks associated with FFS. Among the various gender-affirming procedures, facial feminization surgery (FFS) is arguably the most commonly denied surgery, as insurance companies often deem the involved procedures as cosmetic and not medically necessary. A number of patients had multiple consultations, some consulted legal assistance, and, particularly patients in Groups B and C, some experienced significant distress over the repetitive denials and lack of clarity in the end result of the process. She believes in a shared vision and works closely with her patients to deliver the best quality care that is in line with their needs. Dr. Sajan performs the following Facial Feminization Surgery procedures at his state-of-the-art facility in Seattle, Washington. You need an understanding of your insurance benefits in general: What would any covered surgery cost you? Ainsworth TA, Spiegel JH. You may be trying to access this site from a secured browser on the server. Days, whose birth name was Douglas, came out as transgender in January, 2015. In these circumstances, both complications and revisions are covered as reconstructive procedures, whereas self-pay patients may be responsible for secondary surgical costs. They submit their own information, information about the procedure being performed, and information about you. In Patient X's case, she has achieved the full extent of facial feminization that can be expected with hormone therapy. Facial feminization surgery, or FFS, describes a set of complex procedures designed to "feminize" the face. The cost of the administrative and attending craniofacial surgeon effort for Groups B and C averaged approximately $900, over 20-fold more than Group A. Specific surgical procedures were requested based on patient desires and clinical assessment, with the goal of completing FFS in a one-stage surgery. There are a few limitations in this study that deserve mention. It involves plastic surgery techniques in which the jaw, chin, cheeks, forehead, nose, and areas surrounding the eyes, ears or lips are changed to create a more feminine appearance. Physician wages across specialties: informing the physician reimbursement debate. Procedure. Though specifics required by insurance vary (and might be laid out explicitly in your Certificate of Coverage) I recommend every person have three letters of support. Ultimately, you will need to contact your health insurance company or patient advocate for more specific information regarding costs. 2003; 349:768775. Padula WV, Heru S, Campbell JD. Because the plastic surgeon is not paid on an hourly or salary basis, the national average salary was used.8,9 The estimated cost of the insurance process per patient was calculated by combining the hours spent per step and compensation rates. Administrative time, including obtaining initial authorizations, appeals, IMRs, and additional phone calls, averaged to 7.2 1.0 hours spent per patient. This procedure can alter both soft tissues as well as the facial bone to achieve more feminine-looking facial features. Male-to-female (MTF) facial feminization. It's hard for any person to find their voice to self-advocate when such deeply personal needs are up for debate and judgement as "cosmetic" among random insurance company reviewers. Third, full-face, one-stage FFS is a highly time-consuming surgery due to the multiple anatomical areas addressed at once (averaging 8.5 hours in the senior authors experience). A total of 40 transfeminine patients were identified (mean age 35.6 2.2 years) (Table 1). Some error has occurred while processing your request. Compared with the published literature, patients within Groups B and C are multi-fold greater than the reported standard estimates in the former study without even taking into account time and costs of post-surgical billing activities. The total time from initial consultation to authorization approval in Group B required 7.0 1.1 months, a 6-fold longer process compared with Group A patients (P < 0.001) (Fig. Health insurance might not cover surgical procedures considered cosmetic for the cisgender population people whose gender identity matches the one they were assigned at birth even though these procedures are . During his plastic surgery residency, Dr. Esmonde worked in the Transgender Health Program at OHSU. In total, 4 patients (10.0%) were ultimately denied despite multi-level appeals and IMR requests. Dr. Crane is a board-certified plastic surgeon who performs Gender Affirming Surgery procedures in Austin, Texas. FHS/FFS (Facial Harmonization Surgery / Facial Feminization Surgery) Metoidioplasty/Phalloplasty Vaginoplasty/Vulvoplasty Classes cover the following material: Surgical options and techniques Surgery planning and pathway at Kaiser Post-operative care and recovery Most sessions also include a patient panel Read this first. Furthermore, even in the challenging scenario for insurance authorization reported by Braun and colleagues, Groups B and C also exceed reported estimates. School-Based Dental Sealants; Licensed Rhode Island Dentists. From the cohort, 3 subgroups were delineated. $4985. Please enable scripts and reload this page. Requested CPT codes are detailed in Supplemental Digital Content 1. Read more. Recognized for his exceptional surgical skills and natural-looking results, Dr. Raminenis patients also praise his friendly, compassionate and professional nature. https://links.lww.com/PRSGO/B648.) Privacy Policy (Updated December 15, 2022). Brow Lift. Are there transgender advocacy groups? Some of our patients use Care Credit to cover some of the cost of their facial feminization surgery. to maintaining your privacy and will not share your personal information without Staying in the hospital: Your procedure may be performed in a hospital or outpatient center. Also known as facial feminization surgery or FFS, this is a general term for a group of procedures designed to change the bone structure . The total costs of your Facial Feminization Surgery will be determined by the staff of the University of Miami. 11. Policy Issued By: Anthem. 3. Based in Washington, D.C., Dr. Ramineni performs upwards of 600 surgeries a year and has a specialization in Gender Affirmation Surgery. Unlike California plans, self-insured plans are not under the CA DMHC and, thus, the final outcome is more variable. Thirdly, it is likely that the current work underestimated the total cost of the insurance approval process, as we could not quantify the cost of surgery cancelations, additional clinic visits, and unquantifiable administrative time. Plast Reconstr Surg. Ask them how many FFS surgeries they perform within a year. As much as possible, Dr. Salgado will do what he can to keep costs at a minimum. I recommend the pioneer of FGCS, Dr. Douglas Ousterhouts book, Facial Feminization Surgery: A Guide for the Transgendered Woman for those looking to learn more about what skill and training is involved and a breakdown of procedures as he performed them, but Ill attempt to summarize. The lady on the phone told me the surgery usually ranges from $60-100,000 dollars. Upon receipt of a deposit for your surgery, our practice may offer to submit a prior authorization request to your insurance provider. However, I personally know multiple people who have achieved coverage for FGCS through state Medicaid in both NY and California. Wolters Kluwer Health Leigh JP, Tancredi D, Jerant A, et al. 2. As stated above, all patients within this group were covered by private insurance plans that were not within the purview of the State of California and, thus, were not eligible for state intervention. 50% of transgender women either had or wanted facial feminization (surgery to make a face appear more feminine). Despite the time, effort, and costs incurred, 90.0% of patients were approved for FFS under insurance. Gender-affirmation surgery gives transgender people a physical appearance that aligns with their gender. See the list at the end of this article for surgeons who will accept some form of insurance benefits directly.What makes someone a FGCS surgeon anyway? If your insurance provider approves the authorization request, we may be able to submit a one-time complimentary claim on your behalf. JAMA. Demographic, clinical, and administrative data were retrospectively collected (UCLA IRB #19-001482). We identified all patients with gender dysphoria consulted for FFS under a single surgeon (JCL) at the University of California Los Angeles between January 2018 and February 2020 (n = 55). Your message has been successfully sent to your colleague. Fortunately, as insurance coverage for gender confirmation surgeries has increased, so has physician interest in training. You will be asked to complete an intake questionnaire before your consultation. The benefits of such coverage far exceed the insignificant costs. We believe that for many transgender women, FFS is medically necessary to treat gender dysphoria. We have a dedicated Insurance Advocacy Team that handles the entire process of insurance approval for patients; we send all your documents to your insurance providers and work with them to try and secure coverage to the fullest extent. On average, Dr. Keojampa is booking 8-12 months out for Aesthetic Craniofacial Surgery and Facial Feminization Surgery. Group A is similar to other medically necessary reconstructive procedures where authorization is requested and procedures are authorized. Historically, FFS hasn't been covered by health insurance or government healthcare. They will need letters of support from you for the preauthorization, following WPATHs Standards Of Care. Facial Feminization Surgery (FFS) Preparation Guide. Gray R, Nguyen K, Lee JC, et al. Conveniently Located to Serve Chicago and Illinois. Facial feminization surgery encompasses a broad range of procedures to change the shape of the face to look feminine. Facial feminization surgery (FFS): The permanent . The time and costs necessary to achieve approval from insurance plans for FFS are not trivial. Administrative time in this cohort included obtaining initial authorizations, which resulted in an average of 1.4 0.4 hours spent per patient at an estimated cost of $38.18 10.18 per patient (Fig. Call 913-588-6200 to request a consultation. Related Digital Media are available in the full-text version of the article on www.PRSGlobalOpen.com. The Plastic Surgery Clinic of Chicago personalizes each and every treatment we perform by completing a full facial evaluation and discussing all possible options with you. 1. I cannot tell you what insurance plan to get that covers FGCS, there are too many variables. Patients seeking services from our practice are personally and fully responsible for payment of all fees and costs related to your FFS surgery and medical care. Dr. Youssef is a top Cosmetic Surgeon in the greater Los Angeles area and Director of the Transgender Surgery Institute of Southern California. Please try again soon. For additional assistance with any information contained within this packet, please contact: Oakland MST Department: (510) 752-7149. JCL is additionally supported by the US Department of Veterans Affairs under award number IK2 BX002442 and the National Institutes of Health/NIDCR R01 DE0289098. Mallory C, Tentindo W. Medicaid coverage for gender-affirming care. Ask to speak to people's supervisors. Each letter should state "this procedure is medically necessary treatment. With all letters, I advise providers to be as authoritative in their tone as possible, and to explicitly claim an expert status if appropriate. Procedures requested for facial feminization insurance authorization are detailed in Table 2. These patients underwent a standard approval process no different from other reconstructive procedures (Group A). 816-305-0943 Insurance Note:Utilizing insurance for Facial Feminization and Breast Augmentation procedures - Our office is experiencing reimbursement issues (claims NOT being paid by insurance companies) when filing facial feminization procedures and breast augmentation to insurance. 2019; 144:11591168. Estimated costs of obtaining insurance approval for FFS (B). 5. One of the major issues among surgeons and patients with regard to insurance coverage for FFS is the lack of understanding of the process as coverage for gender healthcare is highly variable depending on state law and plan variabilities (Table 3). While facial feminization surgery has many potential benefits, the decision to proceed . Search by U.S. State, Procedure and Insurance Search by Country and Procedure Browse the Global Surgeon Maps.

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