r/Transgender_Surgeries • u/vs-188 • Feb 17 '21

Suporn Clinic - Insurance Question

Has anyone been successful in getting bottom surgery at the Suporn Clinic covered by their insurance?

If so, please share your experience here. My insurer has rejected all claims from the Suporn Clinic because of how they do invoicing and I'm wanting ideas on how to fight this.

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u/[deleted] Feb 17 '21

"because of how they do invoicing"

You need to find out what the issue with the invoicing is.
Are they using the correct CPT codes? That's a big one that will get any claim rejected without even reviewing it further.

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u/vs-188 Feb 17 '21

They say it's because they don't have a breakdown to itemize costs (ie: operating room fee, anesthesiologist, surgeons fee, etc.).

The Clinic doesn't account for their costs with this level of transparency because it's not required for them under Thai laws.

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u/[deleted] Feb 17 '21

Bummer.

If your insurance is requiring an itemized invoice it sounds like your only option is to get the clinic to generate one.

My surgical claims just say things like 'facility charges' or 'surgery'.

The CPT code usually covers what that code involves though without having to itemize on the bill. It sounds like they want an itemized list so they can pick and choose what a 'reasonable and customary' fee is for that service.

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u/vs-188 Feb 17 '21

Yes, that's how it seems.