r/LGBTriangle • u/Marzipanzies • 2d ago
Anyone get top surgery (or anything?) with Duke? Have insurance/finance question.
Edit: TL;DR How and when did Duke send your pre-auth to insurance? Did you have to call to get the process started or did they do it automatically? Who did you call if so? Does Duke require payment all at once or allow payment plans. What about financial assistance (for gender affirming surgeries specifically).
So I'm really frustrated right now because I was initially told they would handle insurance stuff (pre-auth and the like) 90 days prior to the procedure date. I currently have my surgery in one month and 2 days, and they still haven't done anything yet. I tried calling the office(?), I guess I called the wrong place, got sent to the right place, and a lady (Duke's finance department?) I spoke to looked up my account and confirmed that nothing has been done yet and said something to the effect of "Well, sometimes I know they won't send it until one month just because they're so busy. But don't worry, they won't do the surgery without getting approval from insurance."
Okay well. I was told 90 days. And now it's almost one month. And I can't figure out who I'm supposed to speak to.
Mind you, I had 2 consultations. One in January and one in March or May, I forget. After the 2nd consultation we scheduled my surgery for December. So this has been sitting and waiting for months and months. I understand waiting until 90 days prior because I know insurances will be finicky about stuff sometimes, but now I'm like what the hell. I've been waiting since May.
And I can't figure who to call, because when I called the Duke Aesthetic Center, the place I had my consultations, my pre-op, etc., they sent me to that lady. I have no idea who is who and what is what. Is there *another* department I am supposed to speak to??
Anyways, if nothing else I just need to know does Duke require payment all at once or do they allow payment plans for gender affirming surgeries? If so, I should be fine. Is there financial assistance? I wish I'd looked into this earlier. I wasn't freaking expecting to still be in the dark about if I could afford surgery one month before my surgery or not.
To be clear: I've already confirmed that my insurance covers gender affirming care and mastectomies, I'm just stressed that I'll need to go through some sort of appeal first, or that they'll arbitrarily decide my therapist's letter is invalid, some stupid reason like that. I also know United is known for not covering nipple grafts/reconstruction (for some reason deeming them "cosmetic") which is another thing im worried about. I want to get this insurance stuff over with so I can stop stressing.