Making Sense of Certification Almost everyone has heard that they should look for "board certification" when seeking a qualified plastic surgeon, but it is rarely made clear exactly what that means and what is involved in becoming "board certified". Certification of operating facilities is even more obscure. Who certifies them and what protection does such certification offer? We believe that patients need this valuable information to make informed choices in their search for the right surgeon, surgery facility and anesthesia provider. The American Board of Medical Specialists (ABMS) is the agency that oversees sub-specialty boards. More than 100 "boards" have been submitted to the ABMS for formal approval, but only 24 have met their strict educational and examination criteria. In Plastic Surgery, The American Board of Plastic Surgery (ABPS) is the only ABMS approved board that has traditionally overseen the training and certification of plastic and reconstructive surgeons. When you choose a surgeon who is certified by the American Board of Plastic Surgery, you are assured of proper medical training. The ABPS requires doctors to graduate from an accredited medical school and complete no less than five years of additional residency training, which consists at least three years of general surgery and at least two years of plastic surgery. Comprehensive written and oral exams must also be passed. Certification by other boards does not give you the same protection. Other boards have less strict criteria for certification, and some require only a fee. You may call the ABMS at 1-800-776-2378 or visit the online board certification verification at: www.abms.org www.plasticsurgery.org
Hospital Privileges In general, hospitals only allow doctors who have completed plastic surgery residency programs to perform plastic surgery procedures at their facilities. Ask your doctor what hospitals he or she is affiliated with, and whether you can undergo the procedure being recommended to you at this hospital.
You can verify this information directly with the hospital. If your doctor fails to mention any hospital, and only refers to outpatient surgery centers, take this as a sign to check his or her credentials more thoroughly.
Experience Another factor to consider is your doctor's experience and past results. Ask your doctor about his experience performing the procedure you desire,
ask to see before and after pictures, or ask to speak to past patients. Doctors should be open and willing to discuss their experience and willing to provide you
with this kind of information.
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The expense of cosmetic surgery is dependant upon the procedure being performed. Insurance does not cover cosmetic procedures because they are elective. Cosmetic surgery is your choice and not considered a medical necessity. However, insurance may cover some procedures where a medical or functional need exists.
Most major credit cards are accepted and payment plans are available.
Procedures that may be covered by Insurance
Reconstructive surgery is generally covered by most health insurance policies, although coverage for specific procedures and levels of coverage may vary greatly.
There are a number of "gray areas" in coverage for plastic surgery that sometimes require special consideration by an insurance carrier. These areas usually involve surgical operations which may be reconstructive or cosmetic, depending on each patient's situation.
If a procedure is within these "gray areas," insurance companies often require prior authorization or approval before the surgery is performed and/or extra documentation after surgery to determine how much of the cost of your care they will cover. The following procedures are sometimes covered by insurance when the following symptoms are present:
- Health problems such as back pain, sores, rashes, hernia
- Restricted mobility
- extremely large breasts that cause health problems
- Breast masses or infections
- Lost breast due to disease or accident
- Congenital absence of breast or asymmetry
- Overly developed male breasts (gynecomastia)
- congenitally deformed ears
- Ears that are deformed by disease or injury
- Droopy eyelids that are obscuring vision
- Out or In turned lower eyelids
- Asymmetrical appearance caused by facial paralysis
- Conditions affecting the facial muscles, lips, & cheeks
- Traumatic deformities, head & neck deformities
- Carpal Tunnel Syndrome
- Dupuytren's contracture, tendon & nerve injuries
- Syndactyly (fused fingers) and other congenital deformities
- Deformities from birth defects or disease
- Injuries or nasal deformities that affect breathing
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