How Dr Di Saia Handles Emergency Plastic Surgery
Some of Dr Di Saia's practice involves insurance, but regarding emergency plastic surgery it only does in an indirect sense. Health insurance in Southern California pays poorly for plastic surgery and they take their time to pay. In emergencies this can be really extreme. We used to have outstanding insurance claims for emergencies dating back several years. Now when Dr Di Saia takes call at the hospital and is called in to perform an emergency operation, he routinely bills the patient directly for this work.
The Process for Emergency Patients
When Dr D does an emergency operation at the emergency room, within a few days a bill is mailed to the patient. Patients are usually offered a discount to pay their bill all at once. If they need to pay it over time, a fee agreement can be signed and the bill can be paid over time. This fee agreement involves a small interest rate on the amount outstanding.
Once the bill is paid in full, the office will issue a receipt stating the insurance codes and payment (if requested.) Patients with insurance coverage may then submit this bill to their insurer for reimbursement. Your insurer will screw this up, but patience will usually result in reimbursement. Contact your insurer and ask them what policy they have for submission of this bill. Make it clear to them that you have paid the bill and are seeking to be reimbursed directly. Our office will not cash checks and then pay you. By this time, we have already been paid.
Usually the insurance company representative will insist that they need the doctor's tax ID number to process the forms. We do not give it to them. It is an insurance company trick, so they can issue the practice the check. The insurance company reps always say they need this number and usually send us a letter asking for it. After they don't get it, they almost always (nothing is certain with health insurance and plastic surgery) get around to paying the patient directly.
Notice when your insurance company finally pays you back, how small the check is. This and the time it takes to get it are the leading reasons that for emergencies we don't deal with insurance companies. We do apologize for the inconvenience, but insurance medicine is difficult in plastic surgery.
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© John Di Saia, MD... an Orange County
California Plastic Surgeon
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Please note that this resource is offered freely to individuals considering plastic surgery. No rights are granted and it is not to be reprinted or copied without the author's prior written consent. Understand that some of the information presented may be a matter of professional opinion. Although efforts have been made to assure accuracy, no guarantees are expressed or implied.
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