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Insurance

Your health insurance provider may cover a portion of the cost of your procedure. We may accept insurance from the following providers: Aetna, AvMed, Blue Cross Blue Shield, Humana, Medicare, OneSource, PHCS, United Healthcare and Coventry.

Due to the high volume of insurance requests your insurance inquiry may take up to 3 weeks to verify through our authorizations department. We ask that you investigate your insurance coverage carefully before inquiring with us. This may mean talking with a benefits representative where you work or talking with your insurance company’s member services department. Typically, there is a 1-800 phone number for member services on your insurance card or a listing for an 800 number that you can reach through the operator.

You may want to investigate whether or not you need to have a referral from a specific physician or physician group in order to be covered for mental health or medical services.

 

When calling Member Services please ask the following specific questions to help us get your procedure pre-qualified:

 

  1. Is Dr. Russell Sassani (NPI# 1194788026) a provider with my specific plan? Please make sure that you provide the representative with the NPI number
  2. If Dr. Sassani is NOT a provider, does my plan have out of network benefits?
  3. Does my plan cover gender confirmation top surgery?
  4. How much is my deductible?

Please provide them with ICD-10 code F64.8 and CPT code 19303 (FtoM) or CPT 19325 (MtoF)

Once you have called member services, you may forward your insurance information to surgery@takeshape.info along with a clear copy of your insurance card, a legal photo identification card and your date of birth.

Please keep in mind that in the event that your insurance does not pay any or only a portion of the cost of your health care, the entire bill or remaining balance is your responsibility.

** Additional costs may be incurred for procedures not covered by your plan.**