Insurance Approval, But Decided On A Different Surgeon. Too Late?

I went to a consult today and they are going to file the paperwork with the insurance co. for BR. The only problem is that I went to a different consult with a different PS about a week ago and I like him much better and would like to move forward with him instead. Do I call the other PS office and tell them to not file the paperwork with the insurance company or does it not matter? The PS I am going to use asked me to bring more info to suimbit so he prob has a better chance for approval right?

Doctor Answers 7

Insurance Approval, But Decided On A Different Surgeon

Typically, gynecomastia surgery is not always covered by many insurance or healthcare programs. If it is, it can take some time to acquire approval as criteria can be restrictive. If approved, it's possible to be reimbursed by the insurance company after the surgery. Nevertheless, most plastic surgery offices offer convenient finance plans that allow patients to pay a low monthly payment. 

According to the American Society of Plastic Surgeons the average #cost of #gynecomastia surgery can vary widely. #Surgery quotes should include the procedure itself, operating room facilities, anesthesia fees, surgeon’s fees, medical tests, post-surgery garments, prescription medication and other related costs.  Costs will also vary with geographic location. Estimated costs can be found here on RealSelf.com, PlasticSurgery.org or Surgery.org.

It is imperative you select a plastic surgeon who is #board-certified and has a great deal of experience with male breast #reduction. Plastic surgeons who have specialized in breast surgery and cosmetic surgery are suitable to perform your procedure. Aside from checking board-certification, it is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.


Orange County Plastic Surgeon
5.0 out of 5 stars 106 reviews

Insurance Approval and Switching Doctors

The more surgeons that document criteria needed for insurance approval the better in general. You will have to check with your insurance company re: preferred net work doctors unless you have a POS plan. If so once approved you should be able to pick which doctor you prefer.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 150 reviews

Insurance Approval, But Decided On A Different Surgeon

Each insurance company is different. However, once authorization is given, the process is generally fairly straight forward to change authorization.  The only issue you may have is if the original surgeon is in network and the other one is not. Go with the surgeon that you have a better connection and who you feel will better take care of your needs.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 38 reviews

Breast Reduction through Insurance

Thank you for your question.

Each insurance company is different but normally the surgeon whom you would like to have your surgery with can submit paperwork with your insurance company and ask for the authorization to be switched over to their office.  Usually this is not a complicated process (but again, each insurance company is different).

Good Luck!

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,465 reviews

Breast reduction approval

Go with the surgeon you feel more comfortable with.  Let that doctor submit for you.  Even if the other doctor did so, you should let your insurance company know, and you should politely thank the other doctor's office for their time,etc...

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 26 reviews

Surgical approval

If both surgeons apply for approval, then the insurance company will contact you and ask who you intend to use. If the first surgeon has not submitted a preauthorization, you should request that he not do so. Authorizations are not transferrable from one doctor to another so the second doctor will have to pre certify you independently. The more information, the better so your assessment that you have a better likelihood of approval with the second doctoris correct--assuming that you meet the pre certification criteria.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 36 reviews

Choosing your doctor

You should feel comfortable with your surgeon. Just keep going to who you like and they will take care of the paperwork. You aren't married to a surgeon just because you saw him or her first.

Victor Au, MD (retired)
Chapel Hill Plastic Surgeon
4.5 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.