Insurance Coverage for Plastic Surgery- An Introduction

Health insurance pays for some consultations and procedures in plastic surgery

. Reconstructive procedures within plastic surgery, along with skin cancer excision and other procedures may be covered. Before coming into the office, here are some hints to make the consultation go smoother.

Understanding your health insurance policy, and what you're responsible or not, always helps. You may need to get a referral from your family doctor, or not, before you can see a surgical specialist.

When you come into the office, make sure to have your insurance card with you. If you have 2 or more insurance plans, bring that insurance card as well. With this information, the plastic surgeon's office can bill your health insurance company appropriately.

After the consultation, you and your plastic surgeon will go over the details of what is needed for your procedure. Again, dependingon on what kind of insurance you have, your plastic surgeon may need to get "permission", or "pre-surgical authorization", to do the procedure. Generally, the plastic surgeon's office obtains this by generating clinic notes, submitting photos, and sending all of the paperwork to your health insurance company for approval. Once approval is obtained, then your procedure can be booked. This process takes variable amounts of time, depending on your insurance company.

During this process, ultimately it's your responsibility to know all of the costs involved. Due to privacy concerns, sometimes it's not possible for the plastic surgeon to know every last detail about your coverage. You may have to call the health insurance company directly, or talk to someone in your HR/ human resources department, to figure out what you may or may not be responsible in terms of payment.

It may be helpful to keep a record of all bills, invoices, and paperwork related to your procedure. Written records and names of people you talk to at the health insurance company will also help you keep track of your responsibility of payments. Health insurance companies are known for occasionally being disorganized and bureaucratic, so retaining the original paperwork will help you, just in case an unusual charge pops up in the mail after your procedure.

In general, cosmetic surgery is NOT covered under health insurance plans. The definitions may vary from paln to plan, but overall, your plastic surgeon will want to ethically and legally submit only the proper procedures to your health insurance company for approval.

Your plastic surgeon practices in an ethical manner and will submit claims to insurance carriers only for valid reconstructive plastic surgery. Any attempt to get approval for a a cosmetic procedure as reconstructive is unethical and illegal. Cosmetic procedures are elective and usually not covered under any health insurance coverage. Payment for cosmetic surgery is the responsibility of the patient, and may plastic surgery office accept cash, check, or credit card. There are also some cosmetic surgery financing programs which are available as well.

Insurance Coverage for Plastic Surgery- An Introduction

By: Roy Kim

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