Transgender women may choose FFS as part of their male-to-female transition process. Facial feminization surgery: the forehead. You may be trying to access this site from a secured browser on the server. 2020; 8:e2618. Plastic surgeons at Michigan Medicine are proud to provide Facial Feminization Surgery. *, Time and cost of the insurance approval process for FFS. Analyses of variance with posthoc comparisons under the Tukey criterion were used to compare time from consultation to approval or denial, time spent obtaining insurance authorization, and cost. I always advise people to try with the insurance they have before they switch to another plan. Braun TL, Braun JL, Hernandez C, et al. Group A (standard approval) included patients who were approved after undergoing a standard authorization process, such as those with Medi-Cal, Medicare, and private insurance. This is called facial feminization surgery. In fact, he is one of the most experienced gender surgeons in the world. The remaining 10.0% of patients who were ultimately denied were counseled and in the process of exiting their job-based insurance plan and enrolling for coverage through plans under the health insurance exchange established by the Affordable Care Act, which fall under state jurisdiction. 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. 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. Days, a 50-year-old Berkeley resident, had just returned from a month-long trip to Spain in February, where she underwent a procedure known as facial feminization surgery, or FFS. Canner JK, Harfouch O, Kodadek LM, et al. Facial Feminization Surgery (FSS) Houston and The Woodlands $8995. I could go on about this, but I hate to further the expectation that you must be very mentally ill in order for the "extreme" treatment of FGCS to be warranted. A Systematic Review of Tranexamic Acid in Plastic Surgery: Whats New? Unlike California plans, self-insured plans are not under the CA DMHC and, thus, the final outcome is more variable. 7. Americans who are considering surgery as part of their transition can find the cost of gender-affirming surgery to be steep. 2018; 153:609616. Which, though I knew FFS is expensive, is a bigger estimate than I've ever seen for the procedure. He is also skilled at multiple techniques of Top Surgery, Breast Augmentation and Body Sculpting. Transgender health care coverage | HealthCare.gov Every insurance company is "difficult" to work with. Read your cover in detail and find out the following: Second, find out if yourCertificate of Coveragehas any inclusions (or exclusions) around transgender care. Read more on our Insurance and Finance page. Ousterhout DK. Once you've identified a surgeon who takes your insurance, ask them to submit a preauthorization. In NY, we have the benefit of a clear history of coverage through Medicaid, and plenty of pro-bono legal teams able to help patients with denials. He currently performs approximately 200 genital reconstruction surgery cases per year in Scottsdale, Arizona and Portland, Oregon. Secondly, the current study does not take into account the postsurgical administrative and billing time consumption and costs. These investigators reported patient satisfaction following facial feminization surgery, including outcome measurements after forehead slippage and chin re-modeling. https://links.lww.com/PRSGO/B648.) 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.) Patients seeking services from our practice arepersonally and fully responsible for paymentof all fees and costs related to your FFS surgery and medical care. Dr. Satterwhite is a board-certified Plastic and Craniofacial Surgeon in San Francisco who is dedicated to offering the highest level of surgical care to the transgender community. Once CGSP receives your form, you will be referred to Plastic Surgery for a consultation. It can be just as important or even more important than sex reassignment surgery (SRS) in reducing gender dysphoria and helping trans women integrate socially as women. Facial Feminization Surgery (FFS) in Mexico - MyMediTravel Facial Feminization Surgery: Everything You Need to Know - Verywell Health Facial feminization surgery (FFS) for our male-to-female (M2F) patients can sometimes be the most important decision in your transition. 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. ENQUIRE NOW. 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 . Plast Reconstr Surg. Upon receipt of a deposit for your surgery, our practice may offer to submit a prior authorization request to your insurance provider. To access this service, refer to the process below: Fill out and return the Service Inquiry Form. Procedure. Facial Feminization Surgery - Need FFS? Find the Best FFS Surgeons Get a bossy friend to make phone calls with you while you are dealing with the process. Facial Feminization Surgery | Michigan Medicine - U of M Health These delicate procedures change the male facial patterns to a softer, feminine appearance. During Your FFS Procedure How long it takes: This depends on what you are having done. Submission and review of initial authorization request (1 month); 2. These surgeries can reduce the size and shape of the forehead, alter and refine the nose, make the lips fuller and . Recognized for his exceptional surgical skills and natural-looking results, Dr. Raminenis patients also praise his friendly, compassionate and professional nature. Despite these reports, coverage continues to be variable from state to state, physician to physician, as well as depending on anatomical region. Mallory C, Tentindo W. Medicaid coverage for gender-affirming care. 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. Hormone therapy alone has not sufficiently treated her gender dysphoria, and the next step in her treatment plan is Facial Gender Confirming Surgery." HB2084 (2016) bans gender identity discrimination in health insurance and HB2405 (2022) bans categorical exclusions for gender-affirming care under any health plan, though the law does not . All rights reserved. We are looking forward to meeting you in person, hearing your aspirations, and tailoring a Surgical plan especially for you. Notes. Months required for definitive insurance authorization decisions for FFS. 2018; 319:691697. Dr. Rodriguez is a board-certified plastic surgeon in San Francisco who is dedicated full time to providing surgical care for transgender patients. In general, patients who undergo FFS will stay overnight after their procedure and return home the following day. Known for her surgical skill and artistry, Dr. Nghiems patients also love her kind and caring demeanor. 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? Dr. Crane is a board-certified plastic surgeon who performs Gender Affirming Surgery procedures in Austin, Texas. Tijuana, Cancun, Mexicali, and Monterrey are some of the more popular cities in Mexico for medical tourism and the flowing procedures: Dental treatments including dental surgery. Though WPATH has released the new SOC, it will take insurance companies time to evolve. Facial Feminization Surgery (FFS) Preparation Guide. Coordinating presurgical authorization required an average of 7.8 1.5 hours per patient for the administrator and 4.3 0.5 hours per patient for the attending craniofacial surgeon to navigate multi-level appeals. Padula WV, Heru S, Campbell JD. 10. P < 0.05 was considered significant. It is important to be aware of the side effects that will certainly occur, like swelling, bruising, and incisional scars. 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. We will commonly prescribe you with medications for common post-surgical side effects such as pain, nausea, and constipation. She has a special interest in Facial Feminization and is also highly proficient in Vaginoplasty and Top Surgery. However, I personally know multiple people who have achieved coverage for FGCS through state Medicaid in both NY and California. The analysis was done by identifying individual steps involved in the insurance process (Fig. Administrative costs associated with physician billing and insurance-related activities at an academic health care system. 2018 Physician Compensation Report. Facial Feminization Surgery (FFS) | Gender Affirming Health Program It's an attempt to make the face as attractive as possible for as long as it lasts. Policy Title: Gender Affirming Surgery. Ainsworth TA, Spiegel JH. Call Your Insurance Company to Ask if Gender Affirming Surgery is a Covered Benefit. In September 2022, WPATH released the Standards of Care (SOC) version 8, for trans and gender-diverse medical and mental healthcare. Facial Feminization Surgery Before & After Pictures - RealSelf If you work for an employer who supports your gender confirmation surgery your first point of contact should be your in-house health insurance liaison. This procedure can alter both soft tissues as well as the facial bone to achieve more feminine-looking facial features. All data were analyzed using SPSS software, version 25 (IBM, Chicago, Ill.). Only patients with insurance authorization decisions were included in this study (n = 40). Dr. Charles Shih. Dr. Ramineni is a board-certified plastic and reconstructive surgeon with over 15 years of experience. In addition to legislative changes, the rationale for increasing coverage may be related to calculations on the cost-effectiveness of coverage. 2020 Deschamps-braly clinic. Transgender people report years of battles for health insurance coverage In total, the time consumption of the insurance process was 12.0 1.6 hours and cost $988.38 101.76 per patient. 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. 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. The Ins & Outs of Traveling Abroad for FFS Surgery JAMA Surg. Also referred to as Facial Gender Confirmation Surgery (FGCS), these procedures are becoming more and more popular, and increasingly are covered by insurance. The benefits of such coverage far exceed the insignificant costs. Lastly, a third subgroup of patients (Group C), all with private insurance, were denied for surgery despite multi-level appeals, peer-to-peer discussions, and IMR. Only if your insurance provider authorizes a Letter of Agreement. Dr. Lee has gained worldwide recognition as an FFS specialist after it was announced that he performed Caitlyn Jenners facial . P. Daniel Knott, MD, and Andrea Park, MD from the UCSF Facial Plastic Surgery practice in the Division of Head & Neck Surgery. Insurance coverage for FFS is an important issue for a number of reasons for both patients and surgeons. Thus, specifying any one procedure as medically necessary while excluding other facial procedures reflects a lack of understanding of the nature of the diagnosis. One potential consideration for reducing time and costs is to centralize administrative staff for gender health insurance authorizations. 13. Dr. Rodriguez had 14 years of craniofacial, aesthetic and pediatric plastic surgery experience before becoming a Gender Surgeon. Gray R, Nguyen K, Lee JC, et al. 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 However, we are not responsible for any insurance documentation, reimbursement, denials, or appeals. 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. Male-to-Female Surgery in Texas - Dr. Dulin - MTFsurgery.net Wolters Kluwer Health To filter results, enter information and 'click search icon' and/or select from the dropdown lists. Facial feminization surgery - Mayo Clinic - Mayo Clinic - Mayo Clinic Read on to find out why you might pay more or less, and whether the cost is really worth it. Facial feminization aims to find balance and harmony of the face between shadow and light, masculine and feminine, natural aging and youthfulness. Do you have out of network benefits, or are you limited to providers in the network? Post Surgery Recovery. This means that the surgeon is either already in network with your insurance and is willing to send a prior authorization, or has an office willing to do the legwork of doing a letter of agreement with your insurance. Dr. Lee is a fellowship-trained and board-certified plastic surgeon with deep expertise in aesthetic and reconstructive procedures for the chest/breast and face. The cheapest caesarean section is 48,000 baht (year 2020) including sterilization 53,000 baht. Everyone who is able to fight through it cracks the door open a little wider for the next person. As an example, the typical timeline for our Group B and C patients is as follows: 1. (link is external) for CGSP. Dr. Keith is a board-certified and fellowship-trained Plastic Surgeon with expertise in Gender Affirmation Surgery. 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. Gender-Affirmation Surgery | Transgender Surgery | The University of 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 .
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