Hi all,
In the past few months, I've had a couple of consults in North Carolina for top surgery, and I wanted to share my experiences. This might be long.
The first surgeon I saw was Dr. Eric Emerson. I drove the 2.5 hours to his office in person. The experience was.. not great. I hadn't yet legally changed my name and was deadnamed in the waiting room. I had made the appointment in my actual name, but had to provide it for insurance purposes.
The consult was weird and awkward. I put this down to nerves on my part, but Dr. Emerson didn't seem super interested in what kind of results I wanted. He kept saying he decides based on the patient's body. I like his work, but this understandably made me a little nervous. I didn't get a ton of info out of him, he basically just said ask me your questions and that was the consult. This might have worked out better if I hadn't have been so anxious about showing someone my chest, but that basically ruined my chance to focus and I didn't get much out of the consult.
Either way, I wasn't dissuaded and was informed that his staff would file my insurance claim before we could schedule. His staff are super rude and unhelpful. I dealt with two different women. The first called me and said that I did not meet the conditions my insurance had placed on getting top surgery. She stated that I needed to be on hormones and present as my desired gender for 12 months. I tried to inform her that this was wrong, that I had spoken to my insurance and was sure there was no hormone requirement at least. She argued with me, rather than listen to what I was explaining. I also tried to inform her that I am masculine non-binary and that I've been out longer than 12 months and had told Emerson as such. No luck. I got her to agree to talk to Emerson about that, but she refused to submit my claim if I didn't meet the insurance requirements (even when I tried to explain about potentially appealing a denial).
Got a call the next day from a different lady, who said they would not submit it under any circumstances. She accused me of asking them to falsify information. Still have no idea about that. Then got paperwork from the insurance showing that they had indeed opened the claim, but were refusing to submit my therapy letters, so it would be denied. But that otherwise I was correct that I did not need to meet those 12 month requirements. Had to call the staff again to tell them to please close the claim if they were not going to follow through. They still claimed insurance told them that I had to meet those requirements.
So, long story short, Emerson might be workable if you pay out of pocket, but trying to get them to file my insurance claim was impossible.
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So Joel Beck. He is moving his practice from San Francisco to Charlotte. I had a really good phone consult with him. Chill dude. Would have loved to use him for surgery, but again staff problems. It took about a week before his coordinator got in touch with me. She wanted to clarify that my insurance has a limit on trans surgeries of 20,000 and she thought the facility fee in NC might go over my policy. This was crazy to me. 10,000 seems to be about the expensive end for the entire damn thing. So she said she'd figure out exactly what the fee was. Because of my problems last time, I asked her to file for the insurance claim anyway, and we'd figure the rest out later, but she wanted to give me the quote first. Fair.
She never returned my calls after that. For about a month and a half, I called weekly, left messages, asked the front staff to please have her call me. It's been months now, still never heard anything. Super unimpressed with that. The staff said she's the only one in their office who can handle insurance claims.
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So the good news is I'm scheduled with Hope Sherie for the end of January! I'm paying a little more since she doesn't take insurance outright, but hopefully all will go well with my reimbursement. Her staff is thankfully really awesome. They gave me insurance codes and office info for my filing before even doing a consult. I got my prior authorization no problem. The phone consult with easy and informative, and Dr. Sherie seems really nice!
If anyone has any questions, let me know!
