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Your Insurance Liaison 2017-01-02T22:46:10+00:00

Breast Reconstruction Insurance Coverage and Healthcare Costs

We Take Care of Everything

We are experts in navigating the health insurance process with all of the major insurance carriers.  We take care of that for you.

  • We understand that navigating insurance can be time-consuming, stressful, and even intimidating. Our patients leave all of that to us.

  • We investigate your benefits, provide personal case management and manage all of your insurance carriers requirements for pre-certifications or predeterminations.

  • We also submit all of the billing on your behalf and work directly with your insurance carrier on any appeals or changes to your coverage benefit in order to ensure that you receive the full benefits to which you are entitled.

When it comes to matters of insurance, we work for you! Please call to discuss your insurance coverage and how we can best serve you.

HELPING YOU UNDERSTAND THE INSURANCE BENEFITS PROCESS:

Cancer Rights Act (WHCRA), also known as Janet’s Law, any insurance carrier that covers mastectomy is also required to cover all stages of breast reconstruction regardless of the reconstruction method a woman chooses.

It also covers the reconstruction and restoration of symmetry to both breasts even if only one breast was affected by disease. This includes both implant-based breast reconstruction and natural tissue breast reconstruction and the guidelines apply regardless of whether these procedures are performed at the time of the mastectomy or at a later date.

Breast Reconstruction Insurance Coverage

We have worked successfully for more than 10 years with numerous insurance companies and plans including commercial, self-funded, union, international, Medicare Advantage, Medicare and Medicaid as an out-of-network provider.  In most cases, we have received approval for services by Dr. Levine at the in-network benefit level because of the highly specialized nature of the procedures he offers.

Whether our services are approved in your plan’s network of physicians (“in-network”) or you have the freedom to choose any physician (“out-of-network”) by your insurance carrier, we can advise you in advance of the amount or estimated amount you will be billed for our health care services, if there are any.  This estimate of what you may be billed, except for emergent or unforeseen medical circumstances, is also available in writing upon request.

 
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