.--Insurance/Surgical Coordination


INSURANCE COVERAGE

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DR. JOSEPH CAPELLA IS NON-PARTICIPANT WITH ALL INSURANCE COMPANIES. YOU MUST HAVE OUT-OF-NETWORK BENEFITS.

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HMO'S AND MEDICARE ARE NOT ACCEPTED.

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CHECK WITH YOUR INSURANCE COMPANY TO VERIFY THAT YOU HAVE OUT-OF- NETWORK BENEFITS. CONFIRM YOUR ANNUAL DEDUCTIBLE AND YOUR OUT-OF-POCKET RESPONSIBILITY, WHICH IS A SPECIFIED PERCENTAGE YOU ARE RESPONSIBLE FOR AFTER YOUR DEDUCTIBLE IS MET.



COORDINATING YOUR SURGERY (INSURANCE ONLY)
WE MUST HAVE YOUR DEPOSIT AND MEDICAL DOCUMENTATION FOR INSURANCE 2 MONTHS BEFORE YOUR SCHEDULED SURGERY. THE PRE-CERTIFICATION PROCESS WILL NOT BE STARTED UNTIL WE RECEIVE YOUR DEPOSIT.
 

1)
 

DEPOSIT: REQUIRED 2 MONTHS BEFORE SURGERY. (NO CASH OR PERSONAL CHECKS). YOU MAY USE VISA, MASTERCARD, MONEY ORDER, OR CERTIFIED CHECK.

2)



 

DOCUMENTATION FOR INSURANCE APPROVAL:
FOR PATIENTS HAVING ABDOMINOPLASTY OR A CIRCUMFERENTIAL PANNICULECTOMY (BODY LIFT), YOUR INSURANCE REQUIRES DOCUMENTATION SHOWING THAT YOU HAVE BEEN UNDER CARE FOR INTERTRIGINOUS DERMATITIS (RASHES, SORES, IRRITATION BETWEEN SKIN FOLDS).

 

A)




 

CHART NOTES FROM OFFICE VISITS

YOU MUST OBTAIN CHART NOTES- SHOWING DATES THAT YOU HAVE BEEN TO YOUR DOCTOR (PREFERABLY A DERMATOLOGIST) FOR TREATING YOUR SKIN CONDITION .
 

 

B)



 

LETTER OF MEDICAL NECESSITY

YOU MUST OBTAIN AT LEAST ONE LETTER FROM YOUR DOCTOR STATING THAT IT IS MEDICALLY NECESSARY FOR YOU TO HAVE YOUR EXCESS SKIN REMOVED- ALL DUE TO INTERTRIGINOUS DERMATITIS.


*IMPORTANT*

IF YOU HAVE BEEN PRESCRIBED CREAMS, OINTMENTS, OR MEDICATIONS TO TREAT RASHES, SORES OR SKIN IRRITATION, YOU MUST OBTAIN THAT DOCUMENTATION FROM YOUR DOCTOR OR DERMATOLOGIST, CLEARLY STATING THE NAME OF THE MEDICATION AND HOW YOUR SKIN RESPONDED TO IT.

MANY INSURANCE COMPANIES REQUIRE AT LEAST 6 MONTHS OF DOCUMENTED TREATMENT (SHOWING THAT YOUR SKIN HAS FAILED TO RESPOND TO TOPICAL CREAMS, OINTMENTS, AND MEDICATIONS).


DEPOSIT AND MEDICAL DOCUMENTATION
YOUR DEPOSIT AND MEDICAL DOCUMENTATION CAN BE SENT BY MAIL TO THE FOLLOWING ADDRESS:

DR. JOSEPH CAPELLA'S OFFICE
ATTN: TOBI
545 ISLAND RD. SUITE 2A
RAMSEY, NJ 07446


FAXING MEDICAL DOCUMENTATION
YOUR MEDICAL DOCUMENTATION CAN BE FAXED TO OUR OFFICE :
201-818-0311 ATTN: TOBI


CREDIT CARD PAYMENTS
IF YOU WILL BE MAKING A CREDIT CARD PAYMENT, PLEASE CONTACT OUR OFFICE AT 201-818-9199. (ASK FOR TOBI OR LAUREN).


INSURANCE PRE-APPROVAL
UPON RECEIPT OF YOUR DEPOSIT AND MEDICAL DOCUMENTATION, WE WILL CONTACT YOUR INSURANCE TO REQUEST PRE-APPROVAL FOR SURGERY. WE WILL KEEP YOU POSTED REGARDING THE STATUS OF YOUR PRE-APPROVAL. THIS PROCESS MAY TAKE 1-2 MONTHS, SO IT IS EXTREMELY IMPORTANT TO SUBMIT YOUR DEPOSIT AND DOCUMENTATION ON TIME!

***INSURANCE APPROVAL IS NOT A GUARANTEE OF PAYMENT. WE WILL NOT KNOW EXACTLY WHAT YOUR INSURANCE WILL PAY UNTIL AFTER THE SURGERY IS DONE. ***


QUESTIONS REGARDING INSURANCE PREAPPROVAL AND SCHEDULING
PLEASE CONTACT OUR OFFICE IF YOU REQUIRE ANY ADDITIONAL INFORMATION REGARDING INSURANCE PREAPPROVAL AND THE SCHEDULING OF YOUR SURGERY.

 

INSURANCE PRE-CERTIFICATION
Tobi
Extension: 120    

SURGICAL SCHEDULING
Lauren Lutz
Extension: 119



Back to: Insurance/Surgical Coordination

 
 

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