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Electrolysis Question

Started by Chanteur, March 10, 2018, 10:05:34 PM

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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?


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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.
HRT  5-28-2013
FT   11-13-2015
FFS   9-16-2016 -Spiegel
GCS 11-15-2016 - McGinn
Hair Grafts 3-20-2017 - Cooley
Voice therapy start 3-2017 - Reene Blaker
Labiaplasty 5-15-2017 - McGinn
BA 7-12-2017 - McGinn
Hair grafts 9-25-2017 Dr.Cooley
Sataloff Cricothyroid subluxation and trachea shave12-11-2017
Dr. McGinn labiaplasty, hood repair, scar removal, graph repair and bottom of  vagina finished. urethra repositioned. 4-4-2018
Dr. Sataloff Glottoplasty 5-14-2018
Dr. McGinn vaginal in office procedure 10-22-2018
Dr. McGinn vaginal revision 2 4-3-2019 Bottom of vagina closed off, fat injected into the labia and urethra repositioned.
Dr. Thomas in 2020 FEMLAR
  • skype:Rachel?call
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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?


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