Health Insurance Utilizing coverage under a health insurance plan is often the most affordable way to pay for FFS. Facial Feminization Surgery - Costs - What does FFS cost? - 2pass Clinic See all insurance information. For example, a number of state-mandated denial overturns in Group B patients resulted in billing challenges postsurgery. I always advise people to try with the insurance they have before they switch to another plan. PDF Healthcare Laws and Policies: Medicaid Coverage for Transgender-Related The cheapest caesarean section is 48,000 baht (year 2020) including sterilization 53,000 baht. Recognized for his exceptional surgical skills and natural-looking results, Dr. Raminenis patients also praise his friendly, compassionate and professional nature. Referral letters and supporting documentation should be sent to: UCSF Gender Affirming Health Program 1725 Montgomery St. Suite 250 San Francisco, CA 94111 Phone: 415-885-7770 Fax: 415-353-3399 transcare@ucsf.edu This procedure can alter both soft tissues as well as the facial bone to achieve more feminine-looking facial features. A letter from your primary care provider or whoever prescribes your hormones. Patients were stratified into 3 groups based on authorization process: Group A (standard approval, n = 26, 65.0%) including public and private insurances; Group B (extended approval, n = 10, 25.0%) consisting of private insurance plans that initially denied and required multi-level appeals for denial overturn; and Group C (denial, n = 4, 10.0%), including private insurance plans that denied even after multi-level appeals. We performed a cost analysis of the pre-surgical insurance process for patients seeking FFS. The major difference between approval (Group B) versus denial (Group C) was that the former primarily consisted of plans insured by California and, thus, under the jurisdiction of California law, whereas Group C plans were entirely self-insured employer (ERISA) plans, which are exempt from state regulation. Call Your Insurance Company to Ask if Gender Affirming Surgery is a Covered Benefit. Submission and review of initial authorization request (1 month); 2. However, this is starting to change. Facial Feminization Surgery: What Is FFS, Hairline - Cleveland Clinic Bottom Surgery: Cost, Recovery, Procedure Details, and More - Healthline Please read a few important elements consider when booking. Average months spent from initial facial feminization consultation to final insurance authorization decision. 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. Facial Feminization Surgery - Need FFS? Find the Best FFS Surgeons Dr. Dulin is a board-certified surgeon with many years of experience performing Top Surgery, Metoidioplasty, Breast Augmentation, FFS and Orchiectomy. Plast Reconstr Surg Glob Open. This is highly considered one of the most "life-altering" surgeries for a transgender patient because the impact is visible right away. Facial Feminization Surgery: A Guide for the Transgendered Woman. Dr. Ellie Zara Ley, MD is an accomplished board-certified plastic surgeon who had more than 15 years of specialized training in plastic, craniofacial and micro surgery before learning the art of Gender Confirmation Surgery. Upon denial, an IMR is requested directly from the insurance plan. Bariatric Surgery. Group A averaged 1.1 months for approval, requiring 1.4 hours of administrative time translating to $38.18 per patient. Ultimately this letter is between you and your provider, but here is some sample language that has been helpful to patients I've worked with: "Patient X has been adherent to two years of hormone replacement therapy including (specific estrogen regimen.) Plast Reconstr Surg. Other costs to consider are: Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. FFS can include hairline lowering, jaw reduction, rhinoplasty (nose reshaping), eyelid surgery, face or neck lift, and other facial changes. These procedures are also called Facial Feminization Surgery or FFS, but in agreement with the experts, I've shifted to using FGCS. Dr. Mangubats excellent surgical skills, experience and dedication to transgender health have made him the most sought after surgeon for transgender surgery in the Pacific Northwest. Your health insurance company can't limit sex-specific recommended preventive services based on your sex assigned at birth, gender identity, or recorded gender for example, a transgender man who has residual breast tissue or an intact cervix getting a mammogram or pap smear. Secondly, the current study does not take into account the postsurgical administrative and billing time consumption and costs. Dr. Ramineni is a board-certified plastic and reconstructive surgeon with over 15 years of experience. These investigators reported patient satisfaction following facial feminization surgery, including outcome measurements after forehead slippage and chin re-modeling. In total, attempting and succeeding at obtaining insurance coverage for FFS is a significant time and cost burden that may be difficult to overcome for a number of plastic surgical practices, suggesting ramifications for patient accessibility. A total of 36 patients (90.0%) have been approved by insurance. Facial feminization aims to find balance and harmony of the face between shadow and light, masculine and feminine, natural aging and youthfulness. https://links.lww.com/PRSGO/B648.). All rights reserved. 1. Facial Feminization Surgery (FFS) is a group of facial procedures that alter the face to create more classically feminine characteristics, such as a higher brow, a more refined feminine nose, and less pronounced Adams apple. Mallory C, Tentindo W. Medicaid coverage for gender-affirming care. In total, the time and cost estimate of the insurance appeal process was 10.8 1.0 hours and $855.00 91.53 per patient, respectively. Surgical Staff: 13 surgeons, each specialized in surgery ranging from plastic to maxillofacial surgery. Also known as facial feminization surgery or FFS, this is a general term for a group of procedures designed to change the bone structure . All data were analyzed using SPSS software, version 25 (IBM, Chicago, Ill.). Read more about our Clinics Finance and Insurance Policy here. Received for publication February 2, 2021; accepted February 27, 2021. P. Daniel Knott, MD, and Andrea Park, MD from the UCSF Facial Plastic Surgery practice in the Division of Head & Neck Surgery. Although your FFS may not be covered by your insurance company its definitely worth doing the research. Dr. Rodriguez is a board-certified plastic surgeon in San Francisco who is dedicated full time to providing surgical care for transgender patients. Transgender women may choose FFS as part of their male-to-female transition process. Dr. Freet accepts both insurance and Medicare. He has been performing gender surgery since 2005. Which, though I knew FFS is expensive, is a bigger estimate than I've ever seen for the procedure. Facial feminization surgery (FFS) includes a series of plastic and craniofacial surgical procedures designed to feminize the face. It's an attempt to make the face as attractive as possible for as long as it lasts. FFS consults (n = 40) at the University of California, Los Angeles (20182020) were reviewed for time and cost to definitive insurance authorization decision. Your insurance might have a requirement about length of time in care with them, or degree level. Dr. Sajan performs the following Facial Feminization Surgery procedures at his state-of-the-art facility in Seattle, Washington. Ann Plast Surg. Facial feminization surgery encompasses a broad range of procedures to change the shape of the face to look feminine. In most cases, it is still extremely difficult to get your FFS surgery reimbursed by your insurance. In the Group A patients, FFS under Medi-Cal still requires preauthorization, just like private insurances. Gender Affirming Surgery - Medical Clinical Policy Bulletins - Aetna Insurance coverage for FFS is an important issue for a number of reasons for both patients and surgeons. 2018; 319:691697. His experience in cosmetic and craniofacial surgery makes him an excellent choice for Facial Feminization (FFS) and Masculinization surgeries. Ainsworth TA, Spiegel JH. In total, the time consumption of the insurance process was 12.0 1.6 hours and cost $988.38 101.76 per patient. 2020 Deschamps-braly clinic. Insurance Requirements for Gender Confirmation Surgery - Verywell Health Dr. Javad Sajan - Facial Feminization Surgery (FFS) in Seattle https://links.lww.com/PRSGO/B648.) Second, while complications are not high in FFS, they may occur. Care Credit approval amounts can vary from person to person. This document is a general guide to national resources, but because of the state-specific nature of most insurance regulation, I highly suggest you attempt to reach out to local experts who are better able to advise you to your situation. Because Medicare patients (n = 4) do not need prior authorization, they were excluded from the time and cost analysis of the insurance appeal process for Group A. I tell everyone to plan for an initial denial- even if FGCS is covered in your plan clearly, its likely that portions of the procedure will be denied as cosmetic. Dr. Salgado is a board-certified plastic surgeon with deep expertise in gender-affirming procedures. Read more. Dr. Mangubat specializes in Top Surgery, Breast Augmentation and Body Sculpting, Gender Confirming Facial Surgery and Hair Grafting. Facial Feminization Surgery - A Complete Guide to FFS - DESCHAMPS-BRALY First, one of the most significant barriers to FFS for patients is the ability to pay for surgery, which ranges from $40,000 upwards for full-face, one-stage surgery. Dr. Facque joined the Gender Confirmation Centers team in September 2020 as a full-time Associate Surgeon specializing in Facial Gender Confirmation Surgery, Top Surgery and Body Contouring. I don't philosophically agree with this. He subsequently completed a Gender Surgery Fellowship with Dr. Toby Meltzer and Dr. Ellie Zara Ley. Physician wages across specialties: informing the physician reimbursement debate. Administrative costs have been estimated to account for 31% of health care expenditures in the United States.13 At the level of individual academic surgical practices, contemporary estimations of processing time and total costs for billing and insurance-related activities were 100 minutes and $215.10 for an inpatient surgical procedure in 2017.14 Time and costs for activities carried out by physicians were estimated at a median of 15 minutes or $51.20 for an inpatient surgical procedure.14 In plastic surgery, Braun and colleagues have performed a similar study evaluating the time and cost burden of insurance denials for pediatric patients with congenital breast anomalies.15 Their work estimated that the average pre-surgery insurance process to cost $445.36 and require 7.4 hours of institutional time. While facial feminization surgery has many potential benefits, the decision to proceed . Based on my conversations with friends who are very satisfied with their FGCS, I assure you that no surgery can completely resolve that anxiety. Arch Intern Med. Dr. Satterwhite works exclusively with trans women, trans men and non-binary patients seeking Gender Confirmation procedures such as Vaginoplasty, Facial Feminization, and FTM Top Surgery. Integral to this whole process is the FGCS surgeon. For self-pay patients, cost will frequently dictate the operative and postoperative setting such that patients may be preferentially or solely performed in an outpatient setting. FFS: paying and picking a surgeon. Freaking out and need advice. Group B (extended approval) primarily encompassed all patients who were initially denied but, after undergoing a multi-level appeal process, was ultimately approved. Get a bossy friend to make phone calls with you while you are dealing with the process. 2). If performed all at once, FFS usually takes between 4- 8 hours. 1) and surveying administrative personnel and physicians to determine the approximate time spent on each step. 2010; 19:10191024. Data is temporarily unavailable. A Systematic Review of Tranexamic Acid in Plastic Surgery: Whats New? Facial Feminization Surgery (FFS) - University of Utah 3). Post Surgery Recovery. information about insurance coverage: video.transcendlegal.org 2. Our current work highlights the high likelihood of success in FFS coverage under insurance in California, but also details the challenges that plastic surgeons and plastic surgery practices incur for coverage to occur. To filter results, enter information and 'click search icon' and/or select from the dropdown lists. Starbucks health insurance plans include not only gender reassignment surgery (which had been covered since 2012), but now also a . The report of the 2015 U.S. transgender survey. 4. Dr. Crane is a board-certified plastic surgeon who performs Gender Affirming Surgery procedures in Austin, Texas. 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. Unlike California plans, self-insured plans are not under the CA DMHC and, thus, the final outcome is more variable. to maintaining your privacy and will not share your personal information without $8995. You may be trying to access this site from a secured browser on the server. The pre-surgical authorization process for patients in Groups B and C, constituting 60.8% of all private insurance patients in our cohort, is highly time-consuming due to the individual review periods required for each level. There is also a great deal of discussion on various internet forums and also on social media in terms of how to reduce the cost of your facial feminization surgery by claiming the procedure on your health insurance. Facial feminization surgery (FFS) involves a comprehensive set of procedures to make your face appear more feminine. Both of these methods are. Especially with the establishment of multi-disciplinary gender health teams across the United States, coordination of care through a consistent group of trained administrative staff knowledgeable in the process and appeals process for gender health procedures would potentially reduce the burden on individual offices and surgeons. Due to the gender non-discrimination laws of the state, the denial is typically overturned and the procedures are authorized. Additionally, the patients who exited their employer-based plans to buy health insurance on the exchange paid more for health insurance by foregoing employer contributions. Allure Esthetic & Insurance Coverage For FFS Allure Esthetic is Washington State's top destination for facial feminization surgery. Gender Affirmation Surgery - University of Utah This could include either shaving down or entirely re-contouring the forehead/eyesockets/sinus area using osteotomies (cutting and repositioning bones), shaving the jaw line or a sliding genioplasty (reduction and/or re-positioning of the jaw bone), lifting the upper lip, rhinoplasty (nose job), and bringing the hair line further forward, in addition to other various soft tissue facial adjustments and reduction of the adams apple. Surgeons who practice facial gender confirming surgery often have special training in reconstructing facial features using bone grafting beyond a traditional plastic surgery residency. 2). (See table 1, Supplemental Digital Content 1, which displays requested CPT codes and associated terminology for facial feminization surgery. There are a few limitations in this study that deserve mention. Doctors and nurses take good care. This could be a good time to join (or form!) Dr. Facque is a board-certified plastic surgeon in San Francisco, California who started providing gender-affirming care in 2012 and has worked exclusively with transgender and non-binary patients since 2020. Submission and review of physician-initiated appeal (1 month); 3. He currently performs approximately 200 genital reconstruction surgery cases per year in Scottsdale, Arizona and Portland, Oregon. If it is substantial, they should name their years of experience working with transgender patients. Finding a Surgeon Integral to this whole process is the FGCS surgeon. Staying in the hospital: Your procedure may be performed in a hospital or outpatient center. Plastic surgery on the face. Surgery Scheduling, Rescheduling and Cancellations: Oakland Head and Neck . Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery. Denver Health to Offer Facial Feminization Gender Confirmation Surgery Compared with Group A, the amount of time spent acquiring the authorization was 8-fold higher (P < 0.001), with a 22-fold higher cost (P < 0.001) for the Group B authorization process (Fig. Additionally, the timeline for authorization is relatively opaque, thereby causing more uncertainty in patients and surgeons. Facial Gender Confirmation Surgery or Facial Feminization Surgery (FFS) is a technique utilized to change masculine facial features into softer feminine ones. Body-contouring. All patients with public insurance (Medi-Cal or Medicare) as well as a small subset of private insurance plans were approved after initial submission of authorization request or did not require approval before surgery (Medicare) (Fig. Facial feminization surgery: the forehead. https://links.lww.com/PRSGO/B647.). Other medical procedures like dermatology, orthopedics, gynecology, and ophthalmology. Regardless, I recommend that you fight everything out in the preauthorization/pre service review process, and not after you have already paid and might be left holding the bill. We identified 3 subsets of authorization processes, which partially correlated to the types of insurance plans of the respective patients. By browsing TransHealthCare.org, you consent to our use of cookies and other tracking technologies. As many professions say, past performance does not guarantee future results. However, the tide of change is beginning to roll in- often where Medicaid begins, private plans will be forced to follow, so the clear coverage in California and New York bodes well for everyone. Price on request Facial Feminization Surgery (FFS) View details & Read reviews CALL NOW. Dr. Lee has gained worldwide recognition as an FFS specialist after it was announced that he performed Caitlyn Jenners facial . The standard premium for Medicare Part B in 2020 is $144.60 each month, and there is a $198 annual deductible cost. He works exclusively with trans women, trans men and non-binary patients seeking gender-affirming surgeries, including Phalloplasty, Vaginoplasty and Facial Feminization. Facial Feminization Surgery (FFS) is becoming more and more popular, but it can be hard to narrow down the surgeons who best perform these complex surgeries. First, one of the most significant barriers to FFS for patients is the ability to pay for surgery, which ranges from $40,000 upwards for full-face, one-stage surgery. Facial Reconstruction: Gender affirming facial surgery is considered reconstructive when all of the following criteria have been met: The individual is at least 18 years of age; and According to the Philadelphia Center for Transgender Surgery,. Facial Feminization Surgery (FFS) | Johns Hopkins Medicine In total, 4 patients (10.0%) were ultimately denied despite multi-level appeals and IMR requests. Finally, Group C (denial) included private insurance plans under ERISA that resulted in denial despite multi-level appeals and IMR requested from the plan. Hoang H, Bertrand AA, Hu AC, et al. The multi-level appeal process included physician-initiated appeal, patient-initiated appeal, and independent medical review (IMR). For more information, please refer to our Privacy Policy. You need to come in for an in-person consultation AND pay a deposit to secure your surgery datebeforewe will submit for prior authorization. Gender-Affirming Surgery: Original Article. Facial Feminization Surgery | Michigan Medicine - U of M Health 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.
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