Although revision or secondary surgeries are never intended, the patients are told that there may be future costs if they return to surgery. If the revision occurs within the first 2 years there will usually be similar fees for anesthesia and operating room supplies. The surgeon's fee will usually be greatly reduced.

There are some special circumstances. For example, in breast augmentation there are specific warranties for the replacement of deflated implants.

Either by having physicians accept a "contracted rate," such as in a PPO or provider relationship, or a fixed fee in other managed care arrangements, the doctor, under these circumstances is unable to control his/ or her fees. Confusing statements from the carriers such as "usual and customary" are methods of putting the insured at conflict with the physician and side stepping the issue of failing to pay adequately for insured benefits.

Our office severed all contractual relationships with the insurance carriers as of early 1998. This means that we are neither providers nor are we contracted with any insurance plan or carrier. We are, however, able to bill many insurance policies and the patient is able to receive, often times, significant benefits. Sometimes the insurance company has payment benefits that cover the entire fee. Because the system has become so confusing, we have offered the following procedure with excellent success. All patients are able to come into the office for a "free consult" if it is in order to determine what the prices might be for the proposed services. Normally, the charge to seek information regarding reconstructive surgery is $50.00 or more. At the time of the visit we will give you the following:

An estimate of the charges for the service, i.e. the cost of surgery ( surgeon's fee, pathology, instrumentation, medications, anesthesia — if necessary) We will give you the codes and the diagnoses so that you may contact your carrier to check the benefits. We can mail a copy to your carrier with a photo for more significant procedures. Usually, however, the patient is their own best advocate. Under many instances, the hospital pathology lab or anesthesia department is contracted with insurance plans. It is the patient's responsibility to check this out, however, we will help if possible.

This system has been working out very well for both our existing patients and new patients. We will try very hard to come to a fair price before engaging in care. It may be a reduction from our retail value that we set ahead of time, which will in effect meet the patient or family part way. In this manner we have regained not only some of the control in pricing, but more importantly, we are no longer responsible to the insurance carriers for the decisions that are made in patient care. The decision not to "contract" with insurance carriers for surgeon’s fees has allowed us to spend more time with patients and continue to give excellent and personalized care.

We accept assignment for our patients on Medicare.

For patients who do not have PPO insurance that allows benefits for our operating room facility, we will attempt to provide fees that are priced for the patient prior to the onset of the procedure.

For patients who do not have PPO insurance that allows benefits for our operating room facility, we will attempt to provide fees that are priced for the patient prior to the onset of the procedure.

The office accepts most major credit cards. There are several financing programs available. From time to time we work with different financing companies for our patients. These companies are independent of our practice. Currently, many of our patients have been using Care Credit to finance both their cosmetic and reconstructive procedures.