Dr Rodman is an out of network provider, and unfortunately we are no longer able to authorize or accept insurance. Despite spending countless hours fighting to get cases approved, we have had very little success in recent years. Changes in insurance policies have added barriers that make it nearly impossible. This has caused the process to be prolonged, filled with delays, and often cancelled at the last minute. Patients have been frustrated and angry. This is the opposite of our mission to provide a seamless patient experience and excellent care. We still offer multiple options for financing. Patients who would like to independently pursue using insurance for reimbursement are welcome to do so. We will gladly provide diagnosis codes, procedure codes, and any clinical and surgical documentation needed. Our office team is here to help!
Note this process may take weeks to months. Dr Rodman’s office will follow up with the insurance company once per week. Once codes are approved, the insurance company will need to coordinate with our billing specialist and sign a letter of agreement.
Once the letter of agreement is settled we will look for a facility. We will try to find one in-network with your insurance. Note there are not many facilities that have the equipment to do FFS properly. If Dr. Rodman is not credentialed at a facility approved by your insurance, or said facility does not have the equipment, the patient will have to apply for GAP coverage to get surgery. The surgery must be done in a facility that is safe, well equipped, and knows how to care for trans patients. All surgery centers are not equal, and Dr. Rodman will not compromise quality or patient safety.
Patients who need more than 8 hours of surgery will be required to stay overnight. This may not be covered under insurance. In some cases patients have paid up front and been reimbursed by insurance. Staying overnight is for patient safety and cannot be compromised. There are also some procedures that patients desire, (such as skin tightening with Renuvion) that are not covered under insurance. Patients will be responsible for the cost of these.
If more than 10 hours of surgery is needed, the surgery may be split up into two days. The surgeries can be done one week apart, and the patient will still stay two weeks in Houston. Usually the forehead, nose, and lip lift will be done in the first surgery. The second surgery will be jaw, chin, Adam’s apple reduction, Renuvion skin tightening, face/neck lift, and fat grafting will be performed on the second day. In total, patients should plan to stay for two weeks in Houston.
Denial
In the event of denial, the patient may appeal. In cases where the patient has secondary insurance that may cover the procedures, Dr Rodman’s office can assist with the appeal. For patients who do not have a secondary plan and the procedures are not covered by policy, there is the option of paying out of pocket. Dr. Rodman does have financing options including Care Credit and Alpheon.
Nationally, some patients have gotten legal help to appeal their claim.
Schedule Your Houston Plastic Surgery Consultation Today
The Face Forward process starts with a consultation. You will meet with Dr. Rodman (either in the office or via video call) to discuss the result or look you want to achieve. Dr. Rodman will review and educate you about your options and schedule you for the procedure of your choice. Follow-up appointments will be scheduled as necessary. Achieve your look and enjoy the new you! Schedule your consultation for plastic surgery in Houston at Face Forward today.
1900 North Loop West, Suite 370, Houston TX 77018