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. Wolters Kluwer Health P < 0.05 was considered significant. Despite the time, effort, and costs incurred, 90.0% of patients were approved for FFS under insurance. The multi-level appeal process included physician-initiated appeal, patient-initiated appeal, and independent medical review (IMR). Days, whose birth name was Douglas, came out as transgender in January, 2015. Schedule surgery For additional assistance with any information contained within this packet, please contact: Oakland MST Department: (510) 752-7149. The lady on the phone told me the surgery usually ranges from $60-100,000 dollars. Plastic surgery on the face. J Gen Intern Med. In this work, we report the methods, time consumption, costs, challenges, and successes of our institutional experience on obtaining insurance coverage for FFS. Facial Feminization Surgery - Need FFS? Find the Best FFS Surgeons Dr. Leys multiple plastic surgery sub-specialty fellowships and gentle manner allow her to provide superb surgical care for transgender and non-binary patients. Procedures requested for facial feminization insurance authorization are detailed in Table 2. Co-insurance past that? Bariatric Surgery. Facial Feminization Miami | The Maercks Institute If there is a section on transgender care that explicitly denies coverage for the procedures in Facial Gender Confirming Surgery, as many do, you can still attempt to advocate for them to be deemed medically necessary. Some of our patients use Care Credit to cover some of the cost of their facial feminization surgery. Facial Feminization Surgery NYC | Board Certified Plastic Surgeon Months required for definitive insurance authorization decisions for FFS. 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 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. https://links.lww.com/PRSGO/B648.). Health Insurance Utilizing coverage under a health insurance plan is often the most affordable way to pay for FFS. This is their communication with the insurance company verifying that the procedure is covered. We recommend you take at least two weeks off from work to recover, but expect up to six to eight weeks of decreased activity. 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. The administrator hourly compensation set at our institution was used for the cost analysis. Unlike California plans, self-insured plans are not under the CA DMHC and, thus, the final outcome is more variable. Dr. Thomas Satterwhite 2010; 19:10191024. Forehead (frontal bone recontouring, recontouring of superior orbital rim, hairline lowering). He offers Facial Feminization and Masculinization Surgery as part of the Gender Affirmation Surgery Program at Rush university Medical Center. Woolhandler S, Campbell T, Himmelstein DU. Also known as facial feminization surgery or FFS, this is a general term for a group of procedures designed to change the bone structure . 1. Out-of-pocket costs for FFS. Dr. Mundinger is a board-certified plastic surgeon with extensive training and expertise in craniofacial surgery, microsurgery and gender-affirming surgery. In addition to administrative time, multi-level appeals required time from the attending craniofacial surgeon for peer-to-peer reviews, writing appeal letters, and patient counseling over the 6-month period, in total averaging 3.6 0.5 hours per patient. Facial feminization surgery encompasses a broad range of procedures to change the shape of the face to look feminine. 10. He currently performs approximately 200 genital reconstruction surgery cases per year in Scottsdale, Arizona and Portland, Oregon. Submission and review of second level, patient-initiated appeal (1 month); 4. With a forehead reduction, our aim is to reduce a prominent brow or forehead bossing. 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*,. In practice for more than 20 years, Dr. Salgado performs all aspects of transgender surgeries, from Facial Feminization and Top Surgery, to complex genital procedures such as Vaginoplasty and Phalloplasty. If not, remember youre never alone and there are a range of transgender support agencies that you can tap into. The FFS Surgeons listed below are highly qualified plastic, cosmetic and maxillofacial Surgeons who regularly perform FFS. 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 Timeline - Gender Confirmation 6. (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. Once you've identified a surgeon who takes your insurance, ask them to submit a preauthorization. Start with ensuring that you have an in-depth understanding of your insurance benefits. Dr. Meltzer is a plastic and reconstructive surgeon who has been performing Gender Reassignment Surgery since the early 90s. 2. If your insurance provider approves the authorization request, we may be able to submit a one-time complimentary claim on your behalf. According to the World Professional Association for Transgender Health, facial feminization surgery is particularly inaccessible because almost all insurance companies deem it a cosmetic procedure . 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. 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. 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. The format for an appeals process and regulations/law/policy to cite within it vary widely depending on the mix of state and local regulations that apply to your specific plan. 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. While facial feminization surgery has many potential benefits, the decision to proceed . Dr. Charles Shih. Though WPATH has released the new SOC, it will take insurance companies time to evolve. 2014; 134:609619. Facial Feminization Surgery Cost - American Society of Plastic Surgeons Tate, who has been with Starbucks for 15 years and now manages a store in Austin, Texas, is one of a growing number of Starbucks partners who have used the company's leading-edge benefits for transgender partners. In most cases, it is still extremely difficult to get your FFS surgery reimbursed by your insurance. We are looking forward to meeting you in person, hearing your aspirations, and tailoring a Surgical plan especially for you. Read on to find out why you might pay more or less, and whether the cost is really worth it. Do you have a deductible to meet? One patient may have severe dysphoria over their forehead, while one may have dysphoria over their upper lip. Dr. Salgado is a board-certified plastic surgeon with deep expertise in gender-affirming procedures. For patients anticipating insurance coverage for your surgery, we appreciate that you may wish to seek insurance reimbursement for the cost of some or all of your feminization procedures and have outlined some general guidelines below. Qual Life Res. Osseous transformation with facial feminization surgery: improved anatomical accuracy with virtual planning. PDF Gender Confirming/Grs Surgeon List and Resources for Preparing for Surgery Also referred to as Facial Gender Confirmation Surgery (FGCS), these procedures are becoming more and more popular, and increasingly are covered by insurance. Insurance Requirements for Gender Confirmation Surgery - Verywell Health Based in Beverly Hills, California, Dr. Lee is as well-known for her surgical precision as she is for the compassion, care and understanding that she has for all of her patients. 13. For example, there are now many hospitals across the . This is also the point at which general 201 level guidance ceases to be useful. 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]. Despite improved insurance coverage for gender confirmation surgeries in the United States, coverage for facial feminization surgery (FFS) continues to be difficult. N Engl J Med. 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. Facial Feminization Surgery: What Is FFS, Hairline - Cleveland Clinic 2016. Want to use our data? Facial Feminization Surgeons - Gender-Affirming FFS Surgeons 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. Gender-Affirming Surgery: Original Article. There are a few limitations in this study that deserve mention. He is also skilled at multiple techniques of Top Surgery, Breast Augmentation and Body Sculpting. 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. Male-to-Female Surgery in Texas - Dr. Dulin - MTFsurgery.net Every insurance company is "difficult" to work with. 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. These are usually self-insured employer plans which are administered by well-known insurers such as Blue Cross Blue Shield, United Healthcare, Harvard Pilgrim Healthcare, and Tufts Health Plan. A prior authorization is not a guarantee of payment, therefore, you should have funds available to cover all fees and costs related to your surgery should your request be denied. Once CGSP receives your form, you will be referred to Plastic Surgery for a consultation. However, we are not responsible for any insurance documentation, reimbursement, denials, or appeals. Group B, consisting only of private insurance plans, are processes that initially resulted in denial, thereby requiring multi-level appeals. Finding a Surgeon Integral to this whole process is the FGCS surgeon. 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.) I am working from the perspective that you are unable to pay in full and be reimbursed. Facial Feminization Surgery - Costs - What does FFS cost? - 2pass Clinic Related Digital Media are available in the full-text version of the article on www.PRSGlobalOpen.com. P. Daniel Knott, MD, and Andrea Park, MD from the UCSF Facial Plastic Surgery practice in the Division of Head & Neck Surgery. 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 .
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