The Garramone Center
We have received many requests from patients for us to bill for reimbursement by their insurance carrier for some or all of their FTM Top Surgery Procedure costs. While our practice does not accept insurance as an in-network provider for the FTM Top Surgery Procedure, nor are we contracted with any insurance carrier as a provider, we will help If your insurance allows for out of network coverage, then we can request your insurance company to cover your surgery through our office. (Does not apply to Medicare or Medicaid).
What We Can Provide For Your Out Of Network Insurance Coverage If You Choose To Allow Us To Bill For Reimbursement From Your Insurance?
- Preoperative Authorization: After you schedule your surgery date, you will have to request for “out of network coverage” from your insurance carrier to allow Dr. Garramone to be your surgeon of choice. We will inform your insurance carrier that you have had a consultation with Dr. Garramone and he has determined you to be a good candidate for FTM Top Surgery. We will request authorization from your insurance to provide reconstructive surgical services to you as an “out of network” physician, so we can arrange for approval from your insurance carrier to have your reconstructive surgery covered, and to arrange for our office to be reimbursed directly from your insurance carrier after your surgery. Your insurance will not cover the Cosmetic portion of the procedure which includes all contouring and liposuction.
- If your insurance carrier denies this request for authorization, then you will have to appeal this denial directly with your insurance. If they will not allow us to be an out of network provider, then you will be able to use insurance to get reimbursed after your surgery.
How Does Allowing Us To Bill Your Insurance Benefit You?
If your insurance allows for coverage of transgender surgery and services, then below is a list of why this will benefit you:
- Our Office will bill as an out of network provider for reimbursement by your insurance company. (We will try to get your reconstructive surgical fees reimbursed to you if your insurance allows, minus any deductibles and co-insurance you are required to pay. The cosmetic portion of the procedure is not covered by your insurance company and must be paid before your surgery)
- The Hospital and Surgery Center where the procedure is performed usually will accept your insurance, and will not require you to pay for their services up front. They will bill your insurance to cover the services.
- The Anesthesiologist will usually will accept your insurance and will not require you to pay for their services up front. They will bill your insurance to cover the services.
- Your Prescriptions after surgery will be covered by your insurance. (which is about $100)
- We use a Medical Billing Clearing House, which is a service company we hire and pay to manage all insurance claims. We file your insurance claims electronically. After the claims have been filed, the Clearing House service follows up on all claims and communication with the insurance company. We only hear of the status if we are paid or if the claim is rejected. You do not have to call us repeadetly regarding the status of the claim, as we will only be notified when we are paid or if it is rejected.
This can only occur if we, as the surgery provider, are given permission by you to bill your insurance for the procedure. We will do as much as we can to get your reconstructive surgery covered, but ultimately if your insurance company refuses to pay for the procedure, you will be responsible for the unpaid services.
What We Can Provide For Your FMLA Coverage?
- After you schedule your surgery, we will provide you with a letter to apply for FMLA coverage. You can use this letter before surgery to make sure your FMLA coverage will be active during your recovery period. If you need any FMLA forms to be filled out, we would like you to please fill out all of the information you can and then forward us a copy of your completed FMLA form. We will then attach our FMLA letter, sign your FMLA form, and send this back directly to you for submission to your FMLA provider. The letter looks like this:
“FMLA, disability, or short term leave of absence letter
I am a surgeon duly licensed to practice in the State of Florida located in the United States of America. My medical license number is OS 9076. I am a physician whose office is located at:
4725 SW 148th Ave, Suite 202, Davie, FL 33330
This letter is in regard to my patient, PATIENT NAME, whose date of birth is DATE OF BIRTH. This letter is for the patient to apply for FMLA, disability, or short term leave of absence from work or school or jury duty.
Date condition commenced: SURGERY DATE
Probable duration of condition: 6 weeks from the date condition commenced. After 6 weeks, the patient may return to unrestricted full duty at their place of employment, which is on this date:_______________
Regimen of treatment to be prescribed:
By Physician: basic wound care (instructions given to patient to follow)
By another provider of health , if referred by Physician: none
Is inpatient hospitalization of the employee required?: No
Is employee able to perform work of any kind?: Yes, light duty only after two weeks
Is employee able to perform the functions of employee’s position? Yes as follows:
• only light duty or sedentary position (telephone and computer work okay)
• no heavy lifting over 5 pounds
• no overhead reaching or repetitive use of arms
• arms must remain down by patients side
• no standing for long periods of time
• no climbing, other than stairs
• must be indoors and in a clean dry environment
Did our office prescribe any narcotic prescription medication?: Yes, only to be used during the first two weeks postoperatively as needed, but may show up on drug screening tests for several weeks.
This should qualify PATIENT NAME to be allowed leave of absence from work, school, jury duty, or gym membership.”
Our Commitment To You
Our practice is committed to offering you the best care and we are committed to keeping the cost of your medical care low. We hope this will help you with your transition and help you with the rising costs of medical care that all patients and physicians are facing. Remember, just because a surgeon may be a provider for your insurance carrier, this does not mean they are a qualified expert in performing FTM Top Surgery. Please do not jeopardize your final surgical outcome based on your insurance company’s network of providers. Currently there are many surgeons who are offering FTM Top Surgery services, but there are very few who have adequate experience and very few who are very good at achieving a great result with your first surgery. Please follow the recommendations from other patients who have had a good outcome with an experienced Plastic Surgeon such as Dr. Charles Garramone.
Paying For Your Surgery
Pay using Zelle®
The convenient way to pay for your surgery.
Send all Zelle® payments to firstname.lastname@example.org
- No fees
Other Payment Methods
We also accept all major credit cards and cash. We do not accept checks.
As a service to our patients, we are pleased to offer the CareCredit card, the nation’s leading patient payment program. With CareCredit you can finance 100% of your FTM & FTN Top Surgery and there are no upfront costs, no annual fees, and no pre-payment penalties. So, you can schedule your procedure today and conveniently pay with low, monthly payments.
CareCredit offers a full range of payment plans so you can find one that works best for you. With the popular No Interest Payment Plans* there are no interest charges if you pay your balance in full within the specified time period. Monthly payments can be as low as 3% of your balance. For procedure fees from $1,000 to $25,000, CareCredit offers low interest plan options with low monthly payments available.
CareCredit can be used for future surgeries without having to reapply. And by using CareCredit for your FTM & FTN Top Surgery procedures, you can save your other credit cards for household or unplanned expenses. It only takes a few minutes to apply for CareCredit, and you’ll receive an online decision in seconds!
Apply Now or see our staff for more details.
Your FTM Top Surgery & FTN Top Surgery Journey Starts Here
Flexible appointments and consultations.
Or call us at (954) 752-7842