Electrolysis Question

[Chanteur]

Greetings,

I am looking to begin electrolysis, which from my various calls to insurance appears to be covered. However, they say it requires prior authorization (PA). Also they said I can submit a claim for reimbursement after the fact. They also said it must be done in a medical clinic and by a licensed person.

However, they said only the provider can get the pre-authorization... Which has been my stumble block so far.

Most providers I run into do not deal with insurance since it is normally elective & cosmetic. In fact all the providers ive spoken to said they do not even have computers!

All insurance said for PA is for the provider to call. They will fax a form to be filled out and returned to them...

My question is, how do I go about getting electrolysis, when most of the providers do not seem to know how or want to get the PA? And if I submit my claim after I have done it, that would mean no PA was given. But if I cannot submit for PA myself, how will I get reimbursed?

[Rachel]

I go to a person on Bustleton Pike just north of Philly and she is approved by Aetne. I filled out the prior authorization form and sent it in to Aetna. She received a call and I received a 6 month in network letter. I pay up front and submit the receipts.

[Chanteur]

I live about 1.5 - 2 hours SE of Memphis, TN.

There is 1 center in Memphis that has physician referral section of their webpage, so I assume they have the ability to handle insurance stuff... But it didnt come across that way when I contacted them, but they may outsource their billing.

I will be following up with them again. I do know they have treated other transgender patients as other providers keep bringing up this particular center and when I initially contacted them they were already versed in transition and were asking about hormones and how far along I was in my transition.

Anyone have any information about East Memphis Electrolysis?