Insurance
Increasingly, insurance companies are recognizing the medical necessity of permanent hair removal as part of gender-affirming care.
We encourage clients to call their insurance companies to learn if their plans might reimburse their cost of electrolysis.
Understanding Medical Assistance (MA)
Medical Assistance (MA) is a state-wide program that provides insurance coverage to those without insurance and/or the ability to afford their own insurance. Think of it as a large umbrella that has many sub-programs underneath it.
Goddess Electrolysis is only contracted to work with medical assistance policies (MA) that are managed by Blue Cross Blue Shield. We cannot accept any other form of medical assistance at this time. We encourage folks who want to work with us to call the medical assistance support number in their county and ask to have their MA coverage switched to Blue Cross Blue Shield.
Understanding Commercial Insurance
Commercial Insurance is provided by an employer and/or can be purchased by an individual directly from the open market. Typically, commercial plans have set deductibles, co-pays, and other expenses that will occur when seeking medical care.
Goddess Electrolysis is contracted with Blue Cross Blue Shield of Minnesota, and we can bill your commercial plan directly. If you have commercial insurance through a different insurance provider, we can still work with you under our Insurance Reimbursement Agreement.
Insurance Reimbursement Process
Insurance Reimbursement is a client-driven payment process, meaning it is the responsibility of the client to navigate being reimbursed by their insurance provider.
The Process
-
The client will pay the full rate ($200.00) at the time-of service to their provider.
-
Within 72 hours, an invoice will be sent to the client’s email. This invoice will show that the service was paid in full by the client, and will include all necessary diagnostic and procedural codes.
-
The client then submits the invoice to their insurance provider to be reimbursed. All reimbursements should be sent to the client directly, NOT Goddess Electrolysis.
Best Practices for Navigating Insurance Reimbursement
-
Most insurance providers will require a Prior Authorization before they will reimburse you for our services. Ensure you call and confirm this information with your insurance provider before starting treatment with us.
-
Submit invoices to insurance often AND early. In our experience, some clients have had to discontinue treatment due to the financial strain of having not submitted their invoices for several weeks/months.
-
If insurance denies reimbursements due to information being incorrect/missing, please let us know. Our standard invoice template has a very high success rate of acceptance, however if issues occur we may be able to tweak the invoice to aid in approval.
-
Ensure your insurance provider writes and sends all reimbursement checks to you directly. You have already paid for the service in full, so the reimbursement is due to you, not us.
Prior Authorizations
A Prior Authorization (PA) is a common letter that doctors/nurses send to insurance companies on behalf of their clients explaining the medical necessity of a procedure. Getting a PA approved is usually the key to getting reimbursed!
If you are interested in working with us, we strongly recommend beginning the process of getting a PA approved now. To do this you will need a medical professional (it could be your primary care provider, a nurse in their office, your endocrinologist, your surgery center, etc.) to send a PA request off to your insurance company.
You'll want to include the diagnostic and business codes located in the next section of this page. We have found that even when a client's policy clearly states that gender-affirming hair removal is covered, claims submitted by the client may get denied if they are processed without a prior authorization on file. Should a claim be denied once a prior authorization is already approved, the appeal process is generally much simpler and more efficient.
What information needs to be on my prior authorization letter?
Your medical provider will likely need the following info to complete a Prior Authorization on your behalf:
CPT 17380 (Hair Removal / Electrolysis)
DX F64.9 (Gender Identity Disorder, unspecified)
Goddess Electrolysis LLC
2920 Bryant Ave S Ste 116
Minneapolis, MN 55409
Tax ID: 86-3834822
NPI: 1871167502
We recommend asking them to write the P.A. for 300 hours of electrolysis.
This helps to ensure you are approved for more hours than you will actually need for the entire duration of treatment.
I sent in my prior authorization, but my insurance rejected it. What can I do?
Locate the member services number on your insurance card and call the number. When you call, explain that you are planning to begin medically necessary hair removal as part of gender transition. Tell them you are medically diagnosed with "Gender Identity Order, unspecified" (F64.9 in the ICD-10) and you need hair removal as part of preparation for sex-reassignment surgery." *
You may be told hair removal isn't covered by your plan. For many insurance companies, covering electrolysis is a very new thing, and employees often don't understand the policies around it. If you reach this juncture with insurance, do not give up!
Some insurance companies have specific gender-care reps that help their members navigate prior authorizations and other more nuanced processes related to gender-affirming insurance claims. Keep calling, keep asking questions, and keep a log of everything that is said between you and the insurance reps you speak with. In the world of insurance claims, persistence is key!
* We know this language is outdated and untrue for many folks in our community. Regrettably, using this terminology is often a necessary step in getting clear information from an insurance company that is not designed with trans folks in mind.
While we might not be able to change this (yet), once you are a client at Goddess Electrolysis, we will always use language that feels best for you during your work with us.