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Insurance process?
Posted: Sun Oct 21, 2018 8:29 am
by Nestor
So my insurance DOES cover implants, of course I have a 20% co-pay after my high deductible is met. (So it will still be a bit pricey)
I will need pre-approval. I'm not sure though how that works. I've seen endos over the years, and even originally a local uro. Over the ~15 years I've dealt with this, I've even seen two of the USA's best known men's health specialists.
For an implant, I'd go to one of the best known implant doctor's. So in other words, someone that has no real history with me. How typically do these Dr's handle insurance approval if they don't have that history?
Re: Insurance process?
Posted: Sun Oct 21, 2018 9:04 am
by Floppy
Dr.Eid's office will I know provide you with the information you need, total cost, insurance part, your copay the only thing that they can't tell you is your deductible. They will answer your questions promptly even if you choose to go elsewhere.
Re: Insurance process?
Posted: Sun Oct 21, 2018 5:13 pm
by Bigred
Your physician’s office should handle all the pre-approval from your insurance. They know the proper codes. Be sure to request a copy of the approval from the doctor before the procedure.
Re: Insurance process?
Posted: Sun Oct 21, 2018 8:24 pm
by Nestor
Thank you for your replies.
You're suggesting though a physician that specializes in these surgeries (Dr's Eid and Kramer for instance)... Who haven't treated a patient through other solutions (PDE5's, hormones, etc...) is able to still convince an insurance company that there's a need for surgery?
Re: Insurance process?
Posted: Mon Oct 22, 2018 1:41 pm
by LMCatman
for my first revision (2nd implant), Humana cancelled my authorization the afternoon before surgery. What they finally worked out was an approval for the procedure and hospital with the doctor's name left blank. Dr Perito did not take my insurance. All else was paid by Humana (less deductibles and copays) and I paid Dr Perito myself.....good luck...
Re: Insurance process?
Posted: Mon Oct 22, 2018 4:13 pm
by Bigred
Nestor wrote:Thank you for your replies.
You're suggesting though a physician that specializes in these surgeries (Dr's Eid and Kramer for instance)... Who haven't treated a patient through other solutions (PDE5's, hormones, etc...) is able to still convince an insurance company that there's a need for surgery?
With Kramer, I had to provide medical history showing that I had been prescribed E.D. Meds in the past and had been diagnosed with E.D. His office took care of the rest.