Surgical Fees
The doctor will discuss with each patient estimated fees for his services. Cosmetic fees are pre-determined and pre-paid. For reconstructive cases sometimes the doctor will be unsure of the cost of an operation due to the nature of the reconstruction involved and uncertainty as to how difficult and time consuming it will be. Under those circumstances, he may give an estimated fee range. The final determination of the fee will be made after the surgery is completed and, under extenuating circumstances, may vary from the estimate.

In most cases, you will have a choice of where your surgery is performed; in our nationally accredited in-office operating room, or at a hospital. Generally, the office operating room is more convenient, private, and less stressful. Sometimes, however, due to the type of anesthesia required, a hospital operating room and anesthesiologist are necessary. In that case, Dr. Merkel will operate at Community Hospital or the First Choice/Same Day Surgery Center. A separate fee will be charged for the operating room, regardless of where the surgery is performed, based on the duration of the procedure and materials used. We will advise you of estimated costs for the operating room in advance of surgery.

Follow Up Visits
The surgery fee for reconstructive surgery patients covers all follow-up office visits for 30 to 90 days after surgery. However, if additional time is expended for a new problem or re-addressing an old problem, office visit charges may apply. Additional charges may also be made for supplies used in your care.

Insurance Coverage
Even though we are happy to file a claim with the insurance company for your surgery, please remember that the insurance contract is between you and your insurance company. All charges are your responsibility regardless of your insurance company’s determination of usual and customary fees. Before your surgery, we will contact your insurance company to obtain pre-authorization for your surgery if they will supply pre-approved and/or pre-determination of fees. Not all insurance companies will provide this information. We will estimate your out of pocket expense for things such as deductible, co-insurance, etc., which we request in advance of surgery.

Please provide us with an insurance policy number, address, telephone number and any other pertinent information. This will allow us to file your claims quickly and efficiently. If you want to file your claim yourself, let us know and we will supply you with the proper information to do so. We will file the first claim form at no charge as a courtesy and service to you, however, you may be charged for additional filing of forms, follow-up letters, or phone calls to your insurance company.

Most insurance companies have a schedule of benefits setting “usual and customary” fees for each surgical procedure. Their “80% payment” is based on that fee schedule, not on the amount the doctor has charged. Since the quality of medical coverage varies widely, a reduction in the surgery fee should not imply that the doctor has charged too much, only that the company is trying to control their costs by limiting your benefits.

Read your insurance policies again and again. Be sure you understand the benefits, especially any pre-existing condition clauses. Wait the proper amount of time before consulting any doctor for a condition existing prior to your policy’s effective date. An office visit documenting a pre-existing condition often means a delay of at least a year before surgery can be covered by insurance. Also be aware of the requirements for second surgical opinions, prior approvals, etc.

Aesthetic Surgery & Reconstructive Surgery Not Covered by Insurance
If you are having aesthetic surgery, or any surgery not covered by insurance, we will detail the cost of the procedure during your consultation. We require a 25% deposit at the time of scheduling to hold a surgery date, and the remaining balance two weeks before surgery. In the event we do not receive final payment from you on the date specified, the appointment time for your surgery will be offered to another patient. Your payments should be made by cash or cashier’s check. If unexpected circumstances occur, and you are unable to have surgery on the scheduled date, any advance payment will be held toward a future date.

Financing
We do accept Visa, MasterCard and Discover Card as a convenience to our patients. Many banks and credit unions will consider making loans for medical services. Additionally, we are pleased to offer you information on patient financing programs which have special financing plans for plastic surgery patients. For application information, visit PFS website at: p-f-s.com. If you would like further clarification, or more information, please call our office.

We look forward to serving you!