Copyright TransHealthCare.org & Trans Media Network, 2011-2022. Facial feminization surgery encompasses a broad range of procedures to change the shape of the face to look feminine. Disclosure: All the authors have no financial interest to declare in relation to the content of this article. Other medical procedures like dermatology, orthopedics, gynecology, and ophthalmology. Read on to find out why you might pay more or less, and whether the cost is really worth it. Based in Washington, D.C., Dr. Ramineni performs upwards of 600 surgeries a year and has a specialization in Gender Affirmation Surgery. This is called facial feminization surgery. The time from initial consultation to final insurance denial required 5.1 0.7 months, nearly 5-fold higher than Group A (P = 0.003) (Fig. Total Staff: 34. Facial feminisation surgery can involve a combination of all or some of the below cosmetic procedures. Plastic surgery on the face. Average time spent from administrator and surgeon in obtaining insurance approval for FFS (A). Plastic surgeons at Michigan Medicine are proud to provide Facial Feminization 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. Our surgeons specialize in a variety of facial feminization procedures, such as forehead reduction, jaw contouring, and chin surgery. Wolters Kluwer Health, Inc. All rights reserved. You may be trying to access this site from a secured browser on the server. One potential consideration for reducing time and costs is to centralize administrative staff for gender health insurance authorizations. Recognized for his exceptional surgical skills and natural-looking results, Dr. Raminenis patients also praise his friendly, compassionate and professional nature. Furthermore, revisions may be indicated in some patients over time. Are there transgender advocacy groups? 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. Dr. Mangubat is a board-certified cosmetic surgeon in the Seattle area who has been performing transgender surgery procedures for over twenty years. Conveniently Located to Serve Chicago and Illinois. Other costs to consider are: Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. Resources in other locations are variable, but I'm attempting a general starter guide to FGCS through insurance. Such multi-level appeals begin with a surgeon-initiated appeal, which is then also denied. Prior to meeting with the social worker, patients should complete this assessment document. During Your FFS Procedure How long it takes: This depends on what you are having done. Woolhandler S, Campbell T, Himmelstein DU. In the rare instance that FFS Surgery is included in your health insurance policy, services may be incomplete or function only on a reimbursement basis. Call Your Insurance Company to Ask if Gender Affirming Surgery is a Covered Benefit. Received for publication February 2, 2021; accepted February 27, 2021. Requiring letters from therapists and physicians appeals to some hospitals, surgeons, and care providers, who may look at this system as legally defensible if necessary. 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. Look here for licensed dentists practicing in the state. An estimated 10 patients (25.0%), all with private insurance, underwent an extended approval process requiring multi-level appeals and denial overturn after IMR and frequently, state intervention. $8995. 1) and surveying administrative personnel and physicians to determine the approximate time spent on each step. For trans men, women and gender-nonconforming clients in Los Angeles, Santa Monica, San Diego and elsewhere in Southern California, Dr. Youssef offers Top Surgery, Breast Augmentation and Facial Feminization Surgery. However, the cost can range from $1,847 to $62,000, depending on a few key factors. 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? Facial feminization surgery is more often referred to as "gender reaffirmation surgery", and is performed on . Surgery Scheduling, Rescheduling and Cancellations: Oakland Head and Neck . FFS can include hairline lowering, jaw reduction, rhinoplasty (nose reshaping), eyelid surgery, face or neck lift, and other facial changes. Transgender women may choose FFS as part of their male-to-female transition process. 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. 2016; 31:394401. Finally, you should have an idea of your local resources. I recommend the pioneer of FGCS, Dr. Douglas Ousterhouts book, Facial Feminization Surgery: A Guide for the Transgendered Woman for those looking to learn more about what skill and training is involved and a breakdown of procedures as he performed them, but Ill attempt to summarize. Doctors and surgeons trained in facial feminization surgery are working to improve care for people living with gender dysphoria. All data were analyzed using SPSS software, version 25 (IBM, Chicago, Ill.). A total of 33 patients between 19 and 40 years of age were referred for facial feminization surgery between January of 2003 and December of 2013, for a total of 180 procedures. 2). Dr. Rodriguez had 14 years of craniofacial, aesthetic and pediatric plastic surgery experience before becoming a Gender Surgeon. 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 These delicate procedures change the male facial patterns to a softer, feminine appearance. Our team will help you set up a MyChart account where you will have the ability to fill this out online. 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. Until then, CCTS will continue to require all patients using insurance for . In total, the time consumption of the insurance process was 12.0 1.6 hours and cost $988.38 101.76 per patient. If they are a member of WPATH or other applicable professional associations, they should name that. 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*,. Facial feminization surgery: the forehead. Male-to-female (MTF) facial feminization. Hormone therapy alone has not sufficiently treated her gender dysphoria, and the next step in her treatment plan is Facial Gender Confirming Surgery." Out-of-pocket costs for FFS. Average months spent from initial facial feminization consultation to final insurance authorization decision. Dr. Harris is a highly skilled, board-certified Surgeon in the Dallas area who has been developing an international reputation for transgender surgery. To filter results, enter information and 'click search icon' and/or select from the dropdown lists. Ask to speak to people's supervisors. Additionally, planning and recovering from any trans surgery is hard! Despite improved insurance coverage for gender confirmation surgeries in the United States, coverage for facial feminization surgery (FFS) continues to be difficult. Braun TL, Braun JL, Hernandez C, et al. Research that Matters. Location: Bangkok, Thailand. The total time from initial consultation to definitive authorization decision for Group A was 1.1 0.2 months (Fig. However, this is starting to change. In Patient X's case, she has achieved the full extent of facial feminization that can be expected with hormone therapy. 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. Facial feminization surgery: the forehead. FFS is ideal for trans women and non-transgender women who want a more feminine facial appearance. Submission and review of IMR (1 month). 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). These issues will remedy themselves as you heal, but will often require several weeks to completely resolve. For more information, please refer to our Privacy Policy. 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. With a forehead reduction, our aim is to reduce a prominent brow or forehead bossing. As an example, the typical timeline for our Group B and C patients is as follows: 1. Patients who receive prior authorization are still required to pay for the cost of their facial feminization surgery in advance. A second subgroup of patients (Group B), all of whom had private insurance, were approved for surgery but required multi-level appeals, peer-to-peer discussions, and, ultimately, an IMR. 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 . We're gonna try really hard to get my insurance to cover it, but I'm not holding my breath. A number of patients had multiple consultations, some consulted legal assistance, and, particularly patients in Groups B and C, some experienced significant distress over the repetitive denials and lack of clarity in the end result of the process. Gender-affirmation surgery gives transgender people a physical appearance that aligns with their gender. Please keep track of the mail being sent to the address on file with insurance, as you often are only able to appeal within certain time frames from the initial decision. These patients underwent a standard approval process no different from other reconstructive procedures (Group A). Ultimately, you will need to contact your health insurance company or patient advocate for more specific information regarding costs. Also referred to as Facial Gender Confirmation Surgery (FGCS), these procedures are becoming more and more popular, and increasingly are covered by insurance. Facial feminization surgery (FFS): The permanent . Also known as facial feminization surgery or FFS, this is a general term for a group of procedures designed to change the bone structure . From an historical perspective, both private health insurance carriers and government insurance have declined claims for FFS. Read more on our Insurance and Finance page. In the Group A patients, FFS under Medi-Cal still requires preauthorization, just like private insurances. https://links.lww.com/PRSGO/B648.) *. Tseng P, Kaplan RS, Richman BD, et al. If not, remember youre never alone and there are a range of transgender support agencies that you can tap into. Also referred to as Facial Gender Confirmation Surgery (FGCS), these procedures are becoming more and more popular, and increasingly are covered by insurance. 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. He serves as Division Chief of Plastic & Reconstructive Surgery at Rush University Medical Center in Chicago, and Program Director of the Plastic & Reconstructive Surgery Fellowship. Listings for surgeons outside of the New York area are compiled only for surgeons who perform some combination of genital surgery or FGCS, . 2. Requested CPT codes are detailed in Supplemental Digital Content 1. Surgeries are performed by our world experts in facial reconstructive surgery, including: Drs. Finally, Group C (denial) included private insurance plans under ERISA that resulted in denial despite multi-level appeals and IMR requested from the plan. 2003; 349:768775. The report of the 2015 U.S. transgender survey. This should be sent to you in written form, with the specific reason for the denial included. 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. Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery. Secondly, the current study does not take into account the postsurgical administrative and billing time consumption and costs. Dr. Read more about our Clinics Finance and Insurance Policy here. 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. However, some insurers are beginning to cover FFS from select surgeons. Ousterhout DK. Jaw contouring contours the mandible and narrows a full jaw by reducing angles in the lower face. Doctors and nurses take good care. may email you for journal alerts and information, but is committed Dr. Leys multiple plastic surgery sub-specialty fellowships and gentle manner allow her to provide superb surgical care for transgender and non-binary patients. Dr. Thomas Satterwhite In the standard approval process (Group A), patients were under both public and certain private insurance plans (39% of all privately insured patients in the cohort). 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. This procedure can alter both soft tissues as well as the facial bone to achieve more feminine-looking facial features. Dr. Mundinger is a board-certified plastic surgeon with extensive training and expertise in craniofacial surgery, microsurgery and gender-affirming surgery. Padula WV, Heru S, Campbell JD. Patients were stratified into 3 groups by authorization process. Gender-Affirming Surgery: Original Article. However, this has been a persuasive strategy in some cases. Your message has been successfully sent to your colleague. In these circumstances, both complications and revisions are covered as reconstructive procedures, whereas self-pay patients may be responsible for secondary surgical costs. 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. 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. 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. FFS may include a brow lift, cheek augmentation, rhinoplasty, and lip augmentation. 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. The cost of the administrative and attending craniofacial surgeon effort for Groups B and C averaged approximately $900, over 20-fold more than Group A. 2). 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. She has a special interest in Facial Feminization and is also highly proficient in Vaginoplasty and Top Surgery. Simplifying facial feminization surgery using virtual modeling on the female skull. Dr. Dulin is a board-certified surgeon with many years of experience performing Top Surgery, Metoidioplasty, Breast Augmentation, FFS and Orchiectomy. 3. 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. 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. 2019; 144:11591168. Do you have a deductible to meet? Fortunately, as insurance coverage for gender confirmation surgeries has increased, so has physician interest in training. The surgeons listed below are highly qualified plastic, reconstructive, craniofacial, maxillofacial and cosmetic surgeons who offer gender-affirming facial surgery. Dr. Sajan performs the following Facial Feminization Surgery procedures at his state-of-the-art facility in Seattle, Washington. Despite the time, effort, and costs incurred, 90.0% of patients were approved for FFS under insurance. This is also the point at which general 201 level guidance ceases to be useful. In September 2022, WPATH released the Standards of Care (SOC) version 8, for trans and gender-diverse medical and mental healthcare. Dr. Keith is a board-certified and fellowship-trained Plastic Surgeon with expertise in Gender Affirmation Surgery. This process will be long and draining, but it is worth it. For additional assistance with any information contained within this packet, please contact: Oakland MST Department: (510) 752-7149. Want to use our data? 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. Administrative time in this cohort included obtaining initial authorizations, which resulted in an average of 1.4 0.4 hours spent per patient at an estimated cost of $38.18 10.18 per patient (Fig. This could be a good time to join (or form!) Dr. Sajan places the highest priority on providing his transgender patients with excellent surgical care and natural-looking results. 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.). Facial feminization surgery (FFS) includes a series of plastic and craniofacial surgical procedures designed to feminize the face. Two letters from mental health providers. Facial Gender Confirmation Surgery or Facial Feminization Surgery (FFS) is a technique utilized to change masculine facial features into softer feminine ones. The cheapest caesarean section is 48,000 baht (year 2020) including sterilization 53,000 baht. Every state is different so start with Google and reach out to these services in your state, theyre here for you! 2018 Physician Compensation Report. 2018; 80:198204. A total of 40 transfeminine patients were identified (mean age 35.6 2.2 years) (Table 1). Facial feminization surgery (FFS) is a group of cosmetic procedures that reconstruct facial features that appear masculine and alter them to become more feminine. Lastly, the time consumption, costs, and difficulties to the patient were not assessed. 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. This is their communication with the insurance company verifying that the procedure is covered. Medi-Cal, the California state equivalent of Medicaid, authorizes all gender-affirming surgeries including FFS and Medicare does not require prior authorization. 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. In addition to legislative changes, the rationale for increasing coverage may be related to calculations on the cost-effectiveness of coverage. 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. Dr. Hadeed is a board-certified surgeon who specializes in Transgender Surgery, including chest/breast procedures, facial surgeries and body sculpting for both trans men and women. Despite these reports, coverage continues to be variable from state to state, physician to physician, as well as depending on anatomical region. document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); Facial Feminization Surgery A Complete Guide to FFS, Fat Transfer for Facial Feminization (FFS), Cheek Enhancement (Augmentation & Reduction), Ethno-Specific Facial Feminization Surgery, Forehead Reshaping (Contouring & Reduction), Chin Contouring (Genioplasty/Mentoplasty), Read more about our Clinics Finance and Insurance Policy here, Cheek Enhancement: Augmentation and Reduction, Adams Apple Surgery Augmentation via Natural Implant, Anesthesia and operating room fees (both of which are charged by the duration of time used), Any additional planning/coordination to complete the surgery (VSP, Orthodontic treatment, etc.

Michael Savage Email Address, Articles F