Plastic Surgery - Doctors Who Charge Less to Referred Patients

  1. Hey Ladies,


    Thought some of you might find this article from WSJ interesting!
    :heart:



    Getting a Discount on Plastic Surgery

    [FONT=Times New Roman,Times,Serif]Insurers Start to Offer Access To List of Doctors Who Charge Less to Referred Patients[/FONT]
    [FONT=times new roman,times,serif][FONT=times new roman,times,serif]By RHONDA L. RUNDLE
    May 15, 2007; WSJ - Page D1
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    Face-lifts, tummy tucks, nose jobs and other cosmetic surgeries cost thousands of dollars that health insurance doesn't cover. But some health plans are now offering a new type of benefit -- access to a list of plastic surgeons who have agreed to reduce their fees.
    The price-cutting plastic surgeons are part of something called the American Cosmetic Surgery Network, owned by United Networks of America Inc., which also runs discount programs for prescription drugs, hearing aids, dental care and vision-correction surgery. The cosmetic network offers discounts for surgeries, as well as some nonsurgical procedures including laser hair removal and skin resurfacing. Botox, the popular antiwrinkle drug, is excluded for now.
    The network prices -- such as $6,449 for a face-lift -- can be much lower than comparable local rates. The national average cost of a face-lift is $6,532, according to the American Society for Aesthetic Plastic Surgery, but because fees vary widely by doctor and geographic region, these rates can often be significantly higher. United Networks says its prices represent either a 20% discount off each doctor's typical rate, or a fixed below-market rate, with a cap of $999 set on additional facility fees.
    [​IMG] The network sells access to its doctor lists to individuals for $90 a year. But, increasingly, insurance companies, looking for ways to stand out, are buying the benefit to offer their members access to the discounts. Members present their insurance ID card to qualify for the lower rates. They pay the physician out of their own pocket.
    BlueCross BlueShield of South Carolina and Humana Inc.'s and Coventry Health Care Inc.'s plans in Louisiana are among the insurers who are offering discounts through the network. In February, South Carolina BlueCross BlueShield introduced a benefit that gives members discounts of 20% or more on cosmetic procedures when they use a participating doctor. So far, more than 100 of the health plan's members have scheduled appointments with surgeons around the U.S., says David Boucher, the insurer's assistant vice president for health-care services. The discounts "aren't insurance, but they make our plan more attractive to employers and members," he says.
    AmeriPlan Corp., which sells supplemental health-benefit programs with discounts on services such as vision care, also offers its plan members access to United Networks' physicians. About 30 members a month use the cosmetic-surgery benefit, about the same as for vision-correction surgery, says Julia Baker, senior vice president of provider relations for the Plano, Texas, company.
    Gaining Traction
    Ryan Jumonville, owner of United Networks, which is based in Baton Rouge, La., says the 17-year-old company is finally seeing the plastic-surgery network gain traction after a five-year struggle. In March, at a national conference of Blue Cross/Blue Shield insurers, United Networks was one of several vendors who made a pitch to more than a dozen participating plans. United says it expects much of its growth in coming years to come from its cosmetic surgery network.
    Interest in such networks comes as the number of cosmetic procedures and the number of practitioners offering them has grown in recent years. At the same time, insurance and other medical-payment options such as tax-favored flexible-spending accounts won't pay for purely cosmetic procedures (though they will typically pay to correct a deformity arising from an illness, injury or congenital defect).
    'Value-Added'
    For some people, a cosmetic-surgery benefit can be a deal maker. Susan Stott, age 45, started shopping for a new individual health-insurance policy after the cost of her old coverage went up. Coventry caught her eye because its brochure featured several "value added" programs, including the cosmetic-surgery discount network, which gave it "a little sparkle," she says.
    After becoming a Coventry member, she underwent breast-augmentation surgery last year. The cost was $3,600, about 60% of the market rate, says Ms. Stott, who lives near Baton Rouge.
    Discount networks are a tough sell to plastic surgeons, who seldom sign the sort of business contracts that are common in managed care. They say discount programs tend to attract the least qualified surgeons who can't find enough patients on their own.
    "Those that are experts and leaders in these various areas don't feel like they have to participate because of the value they give in terms of their patient outcomes," says Mark Jewell, a Eugene, Ore., plastic surgeon and past president of the American Society for Aesthetic Plastic Surgery, a professional group.
    Mr. Jumonville says United Networks targets "only board-certified plastic surgeons" and has a rigorous credentialing process. The company tries to persuade doctors that the lower fees they receive will be offset by reduced costs for marketing and administration. "Surgeons don't want to affiliate themselves with a discount program -- that is a term that is almost taboo -- so we have to sell it to them as more of a marketing fee," Mr. Jumonville says.
    Screening Patients
    Mr. Jumonville says his company seeks to protect surgeons by keeping the physicians' names confidential until a prospective patient is screened. The company vets callers to weed out those who are price-shopping or fishing for information. That helps keep the surgeons' fee schedules from public view, and guards against the threat of fee-cut demands from other patients. United staff members also discuss surgery costs and help arrange financing with lenders, if needed.
    [​IMG] The company says about 2,000 procedures have been performed so far through referrals to its network, which includes roughly 600 physicians.
    Patti Kuvelis, a 47-year-old senior-care analyst for the state of California, says she had considered having a rhinoplasty for years after breaking her nose in a car accident. At a cost of about $10,000, a nose job seemed prohibitively expensive, however. Last year, an online search turned up some lower-cost possibilities, including the United Networks panel. For $90, she bought an individual membership and access to the reduced-fee network.
    "I got my card and emailed for an appointment. One of the representatives called me back and we talked for maybe half an hour," Ms. Kuvelis says. She received several physician names, but opted for Robert Winslow, a plastic surgeon in Cameron Park, Calif., about a two-hour drive from her home. To set up an appointment, she paid a $500 deposit.
    In September, she met Dr. Winslow. "He had a great book of before-and-after pictures," she says. He advised her to get a chin implant to aesthetically balance her new nose, and she also had eyelid surgery. The total cost of the three procedures came to about $12,000, after additional savings for paying cash.
    Weighing the Results
    Ms. Kuvelis says that by adding the other procedures, she ultimately paid more than she originally hoped, but feels she got good value for her money. She says she is very happy with the results and figures she saved "a good 50% if not more." She also applauded the follow-up care she has received.
    Dr. Winslow, a 70-year-old plastic surgeon, says he receives only about 40% of his usual fee when patients are referred to him that way.
    His contract is with MyChoice Medical Inc., a subcontractor of United Networks. MyChoice Medical, based in Stroudsburg, Pa., maintains its own network, and solicits patients online through Web sites including looksforless.com and doctorssayyes.com. A menu of "guaranteed lowest prices" is posted on one site, 1800beyourbest.com, promising thigh lifts for $7,999 and liposuction for $2,999. MyChoice Medical officials didn't return calls.
    A Source of Patients
    Dr. Winslow says he signed with MyChoice six years ago, after moving to the community from another California town. "When I'm really busy I don't need them, and when I'm not, it's very handy to have that source of patients," he says.
    He says he gets 100 to 400 referrals a year, which account for roughly a third of his practice. He says he receives about $3,000 for a breast augmentation and about $4,000 for a tummy tuck. (The national average for breast augmentation is $3,544, according to the American Society for Aesthetic Plastic Surgery. But fees vary widely and can range into five figures. The national average for a tummy tuck is $5,263, according to the society.)
    The fees barely cover his expenses, he says, but the referrals "keep me busy."
     
  2. interesting article but PS is one area where i would not be price shopping. too much risk and too many horror stories. the best PS's got their reputations by word of mouth from happy patients and as the article says.... they don't need to offer discounts.
     
  3. I agree I don't want to price shop for plastic surgery. I'm willing to pay for quality. Not that a less expensive doc won't be good but price isn't the first priority.

    Actually though plastic surgery can be a lot more affordable compared to other surgeries because you do have to pay for it out of pocket. I knew someone who had a gallbladder removed and it was $25k. I had a nose job for $6000 or so.
     
  4. Hey Ladies,

    i'm with you. I'd probably pay up and get it done by the top tier surgeons. but it's good to know what's going on in the field and sometimes some people have a budget but they want to get some plastic surgery done you know?

    $25K for the gallbladder removal!! WOW!!! YEEEEKS!!!
     
  5. ok there are some things you just do not try and get a discount on lol.
     
  6. what is the average cost of fat grafting in US
     
  7. i don't know about us clinics but i got my fat grafting in Korea, and the result was very very satisfactory. almost wondering why haven't I got this earlier. for one area it was about 1300 USD. but they gave me some discount since I got multiple areas. for smaller parts like nasolabial fold, it is additional 400 dollars each. pm me if you would like to know the doctor's name and the clinic. i don't want to be banned from here lol
     

  8. Can u share ?
     
  9. It's amazing discount but I really don't know how perfect service they can offer. Can anyone tell me that ?