GRS surgeon and insurance questions

[Amelia Phoenix]

Hey everyone.

I'm at a point where I am starting to begin my search for the right surgeon for GRS. I've found a few names but I was hoping you all would know a few more I can add to my list. My requirements are that they must accept insurance (I live in the United States).

So far I know Dr. Bowers accepts insurance, but from what I've heard her waitlist is three years long, this is a no go for me. I would like to have this done before the end of 2018. Who knows if my insurance will even be around in 3 more years.<bashing remarks removed>

I also know of Dr. Brassard, and he would definitely be my first choice, but I'm receiving some conflicting information. I have a friend who lives in the same city as me who used her insurance with Dr. Brassard about 18 months ago. However, I have heard from many people that you can't use American insurance in Canada, so I'm not sure exactly how she did it. I haven't been able to get in touch with her recently as she is pretty busy with work. Could anyone shed some light on this issue?

Sorry if any of that is incoherent, I've been up all day and just got home from work and thought I'd do a little research. Hopefully you all can help me out. Basically I guess I'm just asking for more surgeons I might not have heard of and some information about health insurance and how it relates to out-of-country surgeons, specifically Dr. Brassard in Canada.

Thanks a bunch!


Moderator Edit:

[KristinaM]

Lookup Dr. Keelee MacPhee in North Carolina. That's who's doing mine in July. No waiting list, and she'll help you file for insurance reimbursement, but doesn't accept it outright.

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[Dani]

Some insurance policies will cover SRS, but most do not. Read the fine print in your policy and see if SRS is on their exclusion list or if their coverage amounts to any thing substantial.

If you have a policy that does cover SRS, then get a prior authorization. Once you get that, see if any SRS surgeons are on their preferred provider list. If no surgeon is mentioned, then talk to your insurance company about reimbursement of your expenses.

I wish I could give you a much better answer. At this time, insurance coverage is spotty at best. I have been through this. Insurance covered my labs and anesthesia, but not my surgeon fees or my hospital stay.

[EmmaLoo]

Even better, ask the practice coordinator to do an insurance pre-determination to find out what exactly will be covered. Insurance coverage is complicated regardless of whether your policy states you have coverage for GCS or not. Much of that coverage is pre-determined by existing contracts within health networks and some are limited further by region.

Once you determine your coverage, and it will vary by the surgeon's location and affiliations, make sure you get a pre-authorization for your procedures. Chances are the surgeon's staff will do that for you.