Cosmetic surgery
Cosmetic procedures are not covered by insurance. When you schedule a cosmetic surgery procedure, we ask you to pay 10% of the surgical fee to hold a specific surgery date. The remaining fees for surgery, the surgical facility and anesthesia (if planned) must be paid one week prior to the surgery date. This is usually done at the time of the second consult for preoperative planning. We accept cash, check, VISA, and MasterCard. Our financial secretary will be happy to discuss payment arrangements that will suit your needs.
Insurance for Reconstructive and Functional Surgery
Your insurance company will consider your surgical procedures and determine if it is “reconstructive and functional” and therefore eligible, for insurance coverage. Examples of procedures that may have insurance approval are breast reduction, nasal surgery for breathing, post-traumatic complications, and birth defects.
Other surgeries may be determined (by your insurance company) to be partially cosmetic and partially reconstructive (such as nasal surgery). In these cases, you will be asked to pay for the cosmetic portion prior to surgery and the reconstructive surgery will be billed to your insurance company. In that case, you will have a co-payment for the reconstructive portion.
Note: Doctor. Kaplan is not a member of any Insurance provider groups. However, we will work on your behalf to obtain authorization for payment to Dr. Kaplan, the surgery facility and anesthesiologists as outside providers. Please bring your insurance forms with you and have your portion filled out and signed to expedite the filing of your claim. You will have a co-payment as determined by your specific medical insurance plan. This will be billed to you after we receive the insurance payment.
PPO
As a courtesy, we will send a letter with an explanation of necessity and appropriate photographs. If we have received a presurgical authorization, we will file your insurance paperwork to help you receive all entitled reimbursements. Upon receipt of an insurance payment, any balance due for co-payment will be billed to you. If you have deposited an excessive co-payment, it will be refunded to you.
HMO
Patients can only be seen if they have obtained a referral from the primary care physician of the HMO. Obtaining a medical referral is the patient's responsibility. We cannot obtain the referral for you, and the referral cannot be obtained retroactively. If you do not have a referral, we will be happy to see you on a cash basis, but your medical insurance company will not pay for your treatment.
Medicare
Medicare pays us directly for your care. You are responsible for any deductible and co-insurance. If Medicare denies your procedure, you are responsible for the charges.
If you have any problems or questions, please ask our staff. They are well informed and up-to-date. Please call if you have any questions or concerns regarding your initial visit.
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