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Schedule surgery They submit their own information, information about the procedure being performed, and information about you. Out-of-pocket costs for FFS. Dr. Javad Sajan, MD is a Cosmetic, Plastic and Reconstructive Surgeon in Seattle who specializes in Gender-Affirming Surgery including Top Surgery, Breast Augmentation, Body Sculpting and Facial Feminization. 2). We detail our institutional experience to provide a roadmap for craniofacial surgeons to navigate the process in an effort to provide higher accessibility to transgender patients seeking facial reconstruction. Start with ensuring that you have an in-depth understanding of your insurance benefits. Choose from multiple implant types and sizes. A letter from your primary care provider or whoever prescribes your hormones. 2020; 8:e2618. 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. (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. Osseous transformation with facial feminization surgery: improved anatomical accuracy with virtual planning. He subsequently completed a Gender Surgery Fellowship with Dr. Toby Meltzer and Dr. Ellie Zara Ley. This could be a good time to join (or form!) Their credential as an MD/DO/NP/PA/MSW/PHD and signature on an essentially form WPATH conforming letter are not sufficient- they need to impress upon the medical reviewers that they are not simply approving your referral request, but are guiding your care as a treating provider, and that this surgery is part of your care plan. Find a Surgeon for Gender Affirming Surgery - TransHealthCare ENQUIRE NOW. The multi-level appeal process included physician-initiated appeal, patient-initiated appeal, and independent medical review (IMR). Gender-affirmation surgery gives transgender people a physical appearance that aligns with their gender. Dr. Dorafshar is a highly distinguished plastic and reconstructive surgeon who specializes in gender-affirming facial surgery. Before getting into the nitty gritty details, let me be real with you, and let me be hopeful. Finding a Surgeon Integral to this whole process is the FGCS surgeon. 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. The report of the 2015 U.S. transgender survey. After a person pays the deductible, Medicare pays 80% of the allowable costs . Patients who are definitively denied (Group C) may then exit their employer-based plan and switch to a plan under California jurisdiction on the health insurance exchange. Read more on our Insurance and Finance page. 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 scars may take up to a year to heal. Price on request Facial Feminization Surgery (FFS) View details & Read reviews CALL NOW. How Do I Pay For Facial Feminization Surgery? - drbastidas.com $8995. Surgical Staff: 13 surgeons, each specialized in surgery ranging from plastic to maxillofacial surgery. 5. 12. Historically, FFS hasn't been covered by health insurance or government healthcare. 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. 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 . Also referred to as Facial Gender Confirmation Surgery (FGCS), these procedures are becoming more and more popular, and increasingly are covered by insurance. Ainsworth TA, Spiegel JH. 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. The addition of multi-level appeals in Groups B and C increased the total time for a definitive decision (7.0 and 5.1 months, respectively) and required both surgeon and administrative time to navigate the process (10.8 and 12.0 hours, respectively). Administrative costs associated with physician billing and insurance-related activities at an academic health care system. 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. This should be sent to you in written form, with the specific reason for the denial included. Procedures requested for facial feminization insurance authorization are detailed in Table 2. Please read a few important elements consider when booking. Gender-Affirmation Surgery | Transgender Surgery | The University of Facial feminization surgery (FFS) includes a series of plastic and craniofacial surgical procedures designed to feminize the face. We recommend you take at least two weeks off from work to recover, but expect up to six to eight weeks of decreased activity. Facial Feminization | Dr. Patel Chicago | MTF Facial Plastic Surgery 2018. When it comes to facial feminization there is no substitute for experience. Call Your Insurance Company to Ask if Gender Affirming Surgery is a Covered Benefit. We are looking forward to meeting you in person, hearing your aspirations, and tailoring a Surgical plan especially for you. Facial Feminization Surgery: Everything You Need to Know - Verywell Health However, its important to be aware that the terms and conditions of many insurance policies do not recognize coverage for the cost of FFS, or may exclude coverage for the services provided to you. Both of these methods are. Facial Feminization Surgery under Insurance: The University - LWW Dr. In the Group A patients, FFS under Medi-Cal still requires preauthorization, just like private insurances. The time spent on the presurgical authorization process for Groups B and C translated to an over 20-fold increase in cost ($855.00 and $988.38, respectively) compared with Group A. Navigation of the insurance process for FFS is challenging and time-consuming; however, coverage is a reality in California provided that multi-level appeals are exhausted. 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. 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? As an example, the typical timeline for our Group B and C patients is as follows: 1. Group A is similar to other medically necessary reconstructive procedures where authorization is requested and procedures are authorized. 10. Finally, you should have an idea of your local resources. Find Dental Health Services: Department of Health - Rhode Island 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. Leigh JP, Tancredi D, Jerant A, et al. Facial feminization aims to find balance and harmony of the face between shadow and light, masculine and feminine, natural aging and youthfulness. 3. 2010; 19:10191024. Facial Feminization Surgery Cost - American Society of Plastic Surgeons 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. Plastic and Reconstructive Surgery Global Open9(5):e3572, May 2021. This guide is 201 level, geared towards those who find themselves covered with an ACA exchange plan or private insurance, as Medicaid processes are much more state specific. 50% of transgender women either had or wanted facial feminization (surgery to make a face appear more feminine). Your message has been successfully sent to your colleague. 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. The time and costs necessary to achieve approval from insurance plans for FFS are not trivial. School-Based Dental Sealants; Licensed Rhode Island Dentists. Plast Reconstr Surg. to maintaining your privacy and will not share your personal information without Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. If they have referenced expert guidelines or current research in devising your care plan, they should state that and provide citations. PDF Facial Feminization Surgery (FFS) Preparation Guide - Thrive See all insurance information. Due to the gender non-discrimination laws of the state, the denial is typically overturned and the procedures are authorized. If they are a member of WPATH or other applicable professional associations, they should name that. Facial feminization surgery is more often referred to as "gender reaffirmation surgery", and is performed on . Some of our patients use Care Credit to cover some of the cost of their facial feminization surgery. Jess Ting - Plastic and Reconstructive Surgery - Mount Sinai Health System Administering cosmetic fillers may take an hour or less, while complex facial surgery may take several hours. 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*,. Please try again soon. The lady on the phone told me the surgery usually ranges from $60-100,000 dollars. Denial overturn was either mandated by the California Department of Managed Healthcare for California-insured plans or by the respective insurance companies for self-insured, employer-based plans under the Employee Retirement Income Security Act of 1974 (ERISA). Demographic, clinical, and administrative data were retrospectively collected (UCLA IRB #19-001482). Facial feminization surgery (FFS): The permanent . Read your cover in detail and find out the following: Second, find out if yourCertificate of Coveragehas any inclusions (or exclusions) around transgender care. Available at: 9. However, the cost can range from $1,847 to $62,000, depending on a few key factors. JAMA Surg. Read on to find out why you might pay more or less, and whether the cost is really worth it. Thus, coverage significantly increases accessibility. 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. Facial feminization surgery (FFS) is a group of cosmetic procedures that reconstruct facial features that appear masculine and alter them to become more feminine. These procedures may include: Tummy tuck, called abdominoplasty. During Your FFS Procedure How long it takes: This depends on what you are having done. Are there transgender advocacy groups? Beginning in June 2021, Dr. Esmonde will serve as a full-time Associate Surgeon with The Meltzer Clinic offering the full spectrum of gender-affirming procedures. Facial Feminization Surgery: What Is FFS, Hairline - Cleveland Clinic The blossoming of academic medical centers offering transgender surgical care also means that more well respected surgeons, with appropriate craniofacial and maxilliofacial reconstructive training, are able to do procedures through insurance. 7. 3). 2). These are difficult to quantify as our institutional billing activities are centralized and carried out by multiple administrators. With a view to clarifying this issue and answering frequently asked questions, we have compiled the following information in an effort to not only outline how Deschamps-Braly Clinic handles finance and insurance coverage but to also provide general information about how to approach your own health insurance company regarding the cost of your facial feminization. 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 Yet, a number of studies have demonstrated that FFS is not only associated with improvement in quality of life for transfeminine patients, but also, for some patients, the most important aspect of transition.47 Although significant barriers exist, an improvement in insurance coverage for FFS has occurred over time, albeit navigation of the process is both laborious and confusing. Each patient is different and your expectations and desired results will be discussed fully in your consultation. The surgeons listed below are highly qualified plastic, reconstructive, craniofacial, maxillofacial and cosmetic surgeons who offer gender-affirming facial surgery. A total of 40 transfeminine patients were identified (mean age 35.6 2.2 years) (Table 1). FFS: money and choosing a surgeon : r/Transgender_Surgeries 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. These patients underwent a standard approval process no different from other reconstructive procedures (Group A). Facial Feminization Surgery: FFS Surgery in Thailand By browsing TransHealthCare.org, you consent to our use of cookies and other tracking technologies. Among the total cohort, most patients had private insurance (n = 23, 57.5%), followed by Medi-Cal (n = 13, 32.5%), and Medicare (n = 4, 10.0%). The Ins & Outs of Traveling Abroad for FFS Surgery 2016; 137:438448. The FFS Surgeons listed below are highly qualified plastic, cosmetic and maxillofacial Surgeons who regularly perform FFS. One of the greatest joys in my trans community work is helping people navigate Facial Gender Confirming Surgery. Submission and review of IMR (1 month). Post Surgery Recovery. He joined the Austin branch of the Crane Center for Transgender Surgery in 2021, where he offers Top Surgery and Breast Augmentation, Facial Feminization and Vaginoplasty. 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. 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. Which, though I knew FFS is expensive, is a bigger estimate than I've ever seen for the procedure. Medi-Cal, the California state equivalent of Medicaid, authorizes all gender-affirming surgeries including FFS and Medicare does not require prior authorization. If your insurance provider approves the authorization request, we may be able to submit a one-time complimentary claim on your behalf. Starbucks offers expanded benefits for trans people However, we are not responsible for any insurance documentation, reimbursement, denials, or appeals. He offers Facial Feminization and Masculinization Surgery as part of the Gender Affirmation Surgery Program at Rush university Medical Center. Patients seeking services from our practice arepersonally and fully responsible for paymentof all fees and costs related to your FFS surgery and medical care. 2016; 31:394401. Starbucks health insurance plans include not only gender reassignment surgery (which had been covered since 2012), but now also a . 2. 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. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. Dr. Rodriguez had 14 years of craniofacial, aesthetic and pediatric plastic surgery experience before becoming a Gender Surgeon. 6. Everyone who is able to fight through it cracks the door open a little wider for the next person. We can't guarantee insurance coverage but we can guarantee to try our hardest! 2019; 144:11591168. I am working from the perspective that you are unable to pay in full and be reimbursed. Look here for licensed dentists practicing in the state. FFS: paying and picking a surgeon. Freaking out and need advice. Los Angeles, CA: University of California, Los Angeles School of Law; 2019. These procedures are also called Facial Feminization Surgery or FFS, but in agreement with the experts, I've shifted to using FGCS. This could be replaced with language about how you are not eligible to take estrogen therapy for whatever reason, including fancy language for just not wanting to. How soon can I book a surgery date? For Bay Area trans women, facial feminization surgery helps complete This work was supported by the Bernard G. Sarnat Endowment for Craniofacial Biology (JCL) and the Jean Perkins Foundation (JCL). Some error has occurred while processing your request. We identified 3 subsets of authorization processes, which partially correlated to the types of insurance plans of the respective patients. Facial Feminization Surgery: What You Should Know - Healthline Our team will help you set up a MyChart account where you will have the ability to fill this out online. 3). 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]. Facial Feminization Surgery (FFS) in Mexico - MyMediTravel FFS consults (n = 40) at the University of California, Los Angeles (20182020) were reviewed for time and cost to definitive insurance authorization decision. 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. Facial feminization surgery encompasses a broad range of procedures to change the shape of the face to look feminine. Insurance and facial feminization surgery - 2pass Clinic All data were analyzed using SPSS software, version 25 (IBM, Chicago, Ill.). This operation is most commonly performed in transgender women or non-binary people as a type of gender-affirming surgery. Second, while complications are not high in FFS, they may occur. This study highlighted the successes and burdens associated with obtaining insurance authorization for FFS. 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. Listings for surgeons outside of the New York area are compiled only for surgeons who perform some combination of genital surgery or FGCS, . Jess Ting - Plastic and Reconstructive Surgery | Mount Sinai - New York Home Profiles Mount Sinai Doctors Video Visit Available Accepting New Patients Jess Ting, MD Plastic and Reconstructive Surgery 4.6 Star s | 32 Responses CTMS 212-870-8270 View location details Book an Appointment About Me Clinical Focus Video Education & Certifications Awards William Hoffman, MD and Jason Pomerantz, MD from the UCSF Division of Plastic Surgery, and Drs. 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. 2). TransHealthCare.org uses cookies and other tracking technologies to improve your browsing experience on our website, to analyze our website traffic, and to understand where our visitors are coming from. Submission and review of physician-initiated appeal (1 month); 3. Bottom Surgery: Cost, Recovery, Procedure Details, and More - Healthline Facial Feminization Surgery FFS Insurance Coverage 1). (link is external) for CGSP. Dr. Dulin is a board-certified surgeon with many years of experience performing Top Surgery, Metoidioplasty, Breast Augmentation, FFS and Orchiectomy. Dr. Sajan places the highest priority on providing his transgender patients with excellent surgical care and natural-looking results. In contrast, FFS under insurance coverage allows for inpatient care, which may be important, particularly to surgeon decision-making as well as patients who may have other medical conditions, pain control issues, or those who travel from long distances. Some will result in eventual approval (Group B) and others will result in eventual denial (Group C). This guide may also be useful for people planning other procedures considered cosmetic and/or explicitly listed as not covered under their transgender benefits (breast augmentation, body contouring, facial masculinization surgery, etc.). Modeling performed by Padula and colleagues for employer-based insurance plans in Massachusetts indicated that, over the course of 5 years, coverage for transition-related services would lead to societal costs of $0.016 per month per member.3 The authors concluded that the relatively low societal cost, combined with the increase in quality-adjusted life years for transgender patients, supported coverage of transition-related services in employer-based plans. On average, Dr. Keojampa is booking 8-12 months out for Aesthetic Craniofacial Surgery and Facial Feminization Surgery. From an historical perspective, both private health insurance carriers and government insurance have declined claims for FFS. Here, we describe our institutional experience on navigation, time, and costs of the FFS insurance authorization process. These letters, in addition to following the WPATH standards of care, are the place to communicate the severity of the dysphoria- does your dysphoria impede activities of daily living, for instance by making you unable to leave for work on time? 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. Dr. Lee has gained worldwide recognition as an FFS specialist after it was announced that he performed Caitlyn Jenners facial . This procedure can alter both soft tissues as well as the facial bone to achieve more feminine-looking facial features. Body-contouring. Thus, coverage significantly increases accessibility. Dr. Meltzer is a plastic and reconstructive surgeon who has been performing Gender Reassignment Surgery since the early 90s. Known for her surgical skill and artistry, Dr. Nghiems patients also love her kind and caring demeanor. Insurance authorization process for FFS.The insurance authorization process for FFS begins with submission of two letters of support from a mental health provider and primary care physician following surgical consult.