For women one of their top concerns when looking towards Breast Reduction is the pain that is associated with this condition. Breast reduction is very important to women and to Dr. Jacobsen as well. For Dr. Jacobsen, this means taking care of those needing help alleviating back, neck and shoulder pains that come from the grooving of their brassiere. It can be difficult to get coverage from your insurance; however, Dr. Jacobsen can be your best advocate, and will do everything he can to help you get this approved.
Self-pay is always an option at our office, as apart of our practice we have included options for financing and payment plans:
Almost all women wish to have their insurance company pay for this. Most insurance companies make this very difficult and do not wish to pay for this type of service, making it very difficult to be approved and authorized for surgery. Reading the material below will help yourself a great deal through this process. As a specialist in restorative and plastic surgery, Dr. Jacobsen is practiced and will write the necessary documentation in your best interest to help get you approved. If you wish to have your surgery, you may, at any time take the course of self-pay if you are safe for anesthesia. Call and schedule a consultation with the office to see if you can be approved for this.
If you wish for your insurance company pay, you must follow their rules! Dr. Jacobsen and his staff are not in control of their rules or their approval process. Our staff is experienced in requesting authorizations from insurance companies, but greater than 90% breast reduction surgeries are denied by insurance companies. You must work hard and fight for your approval!
Below, we have prepared this document to help you with the insurance approval process:
Common Breast Reduction Misunderstandings
- Patients feel because they are suffering that your insurance company will cover the surgery.
- Patients feel that because their doctor said they needed breast reduction surgery that their insurance company will cover it.
- Patients feel if that if Dr. Jacobsen just words his notes properly the insurance company will cover it.
These are false
By allowing Dr. Jacobsen to take over your care, Dr. Jacobsen will act as your best advocate. You can be assured that his notes will be very detailed and supportive. However, Dr. Jacobsen’s opinion alone is not final. The insurance company’s decision may rely ENTIRELY upon supportive documentation from other supporting providers. By meeting the criteria and having all the appropriate documentation on your behalf will allow for the greatest chance to be approved and covered by your insurance. These can be located by speaking with your insurance company.
Every insurance carrier is different and has a different process.
Steps to Finding Insurance Criteria
- Call your carrier and find the criteria they have for breast reduction surgery in your policy.
- Call your carrier and get a copy of your policy.
- Printout the criteria for breast reduction surgery.
- Document how you meet each criterion your insurance carrier has listed
If you contact your insurance, it is essential to tell and let your representative know that this breast reduction surgery is necessary to your health and well-being. They should be able to give you the exact criteria they use to approve breast reduction surgery.
By obtaining medical records, you can help yourself with the most important part of the approval process; Supporting documentation of problems relating to the size of your breasts and the wish to resolve this by having breast reduction surgery.
Dr. Jacobsen’s staff will not obtain these records for you. If you wish to have your insurance company approve your surgery, you must obtain the records, email and/or fax them to us
Once you meet the criteria you cannot be denied for surgery! If you want your surgery work on this diligently.
List of Medical Records Needed for Approval:
You can send these to Dr. Jacobsen’s office
- Primary care physician
- Referring physician
- Back or spine physician
- Physical therapist
- Records from any other non-surgical physicians
You can be your own best advocate by physically getting your own records. You must go to your doctor’s office and request these records and bring them to our office.
Records can be faxed to 602279.1701 or emailed to emaildrj.com.
The best method is sending your records on your own behalf, oftentimes by calling other offices and asking them to fax your information usually fails. As offices can be extremely busy and sending records becomes of low priority when dealing with higher risk patients. We receive all faxes electronically, so we do not miss any faxes. We recommend going to your doctor’s office to obtain copies and bringing them at time of appointment. We will not call your doctor’s office to retrieve documentation. Once we receive your documentation, we will be happy to submit them to the insurance companies on your behalf. We cannot be your administrative assistant. If you wish your surgery to be approved you must obtain your records on your own.
Call your carrier during the approval process:
- They can help give you the status of your approval or denial.
- Insist that they tell you why you are not approved.
- Insist that they tell you specifically what criteria you have not met.
- Do not believe them when they say you are denied because Dr. Jacobsen did not do the authorization properly.
Be Aware of Carrier’s excuses
Insurance companies will often tell patients that they are not approved by fault of the practitioner, and they are the cause of your denial. To avoid this, make your carrier explain to you what criteria you do not meet exactly!
Be assured once we receive records we have done everything properly and timely. Our office handles the insurance authorization process daily, quickly with no problems and knows exactly how to do it. Before taking any complaints to the office make sure of the denials you are receiving from the insurance carrier. Authorizations are based solely on the criteria you receive from your insurance company.
If your surgery is still denied by your insurance company, we will be happy to work with you. Attached is an Estimated Cost for Surgery for your information. After a consultation, we will prepare a more accurate personalized Financial Commitment for Surgery for you.
At any time during this process, you can contact our office for an update on status or to answer any questions you may have at emaildrj.com.
And remember . . . You must work hard and fight for your approval!
Breast Reduction Phoenix – Pricing
|Total All-Inclusive Fees||$||8,880|
|Dr Js Surgical Fees||$||4,750|
|Payment to Dr Jacobsen||$||6,120|
|Estimated Anesthesia Fee||$||~890|
|Payment to St Joe’s SurgiCenter||$||1,870|
Note: This is a pre-examination estimate that is appropriate for most patients wishing this service. The fees may change slightly based on your personal needs.
Dr J and his staff look forward to understanding the details of your unique case, desires and aspirations, and to providing you with realistic, safe and attainable results that leave you looking beautiful, and truly feeling like yourself. Take the first step toward your healing or rejuvenating procedure with Dr J by filling out our contact form to request a consultation, or to inquire about any of the services we offer. We look forward to treating you!
Get started today!
Dr J and his staff are committed to providing you with exceptional and compassionate care. On behalf of our entire team, we invite you to request a consultation to talk to Dr J about your goals, expectations and aspirations. We can’t wait to find out how our 20-plus years of experience in cosmetic and functional plastic surgery can help change your life, and make you a happier, healthier person.
Dr. William Jacobsen
2525 East Arizona
Biltmore Circle, Ste C236
Phoenix, AZ 85016
Our Procedures & Treatments
Dr J considers every surgery an opportunity to express his vision with his patients, and believes in natural, beautiful results that leave you feeling confident and beautiful, but most importantly, feeling like yourself. From extremely rare and complex surgical cases, to cosmetic surgery, Dr J has the experience, compassion and understanding to help you achieve your surgical goals.