Welcomed Insurance Plans

MobleyMD is recognized internationally as one of the top Facial Plastic Surgery practices in the US.

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INSURANCE AT MOBLEYMD

What are my
insurance options?

Mobley MD proudly accepts a wide variety of insurance plans. Learn more about how we work with insurance companies below. If you require any assistance with understanding how insurance works for Facial Plastic Surgery, please contact us.

Welcomed Insurance Plans

At Mobley MD, we are proud to offer our patients a wide selection of welcomed insurance plans and providers. View our list of providers below:

Altius
Blue Cross Blue Shield (Exception is Focal Point)
Cigna
DMBA
EMI
Humana Choice Care PPO
PEHP (Exception is Advantage)
Workman’s Comp
Wise
Aetna
Ameriban (3rd party through Aetna)
Alliant/PHCS
First Health*** Any that offer an IHC subsidiary would be out of network)***

At this time, Mobley MD does not accept the following insurance plans. If you have any of the below providers, you will need out of network benefits to be a patient of MobleyMD.

Select Health
United (UMR)
Bridgespan
Tricare
Beech Street
Medicaid
Molina

Choosing an Out of Network Surgeon

One of the most important decisions one can make is who will operate on your face or nose. The results of nasal and facial surgery are right in the center of your appearance for all the world to see and we each experience nasal function with every breathe we take and especially at night when we sleep.

Dr. Mobley frequently cares for many patients with surgically complex problems that other surgeons may not feel comfortable or capable of treating. Dr. Mobley is extremely skilled in revision nasal surgical procedures and complex facial reconstructive surgery. Unfortunately, not all private insurance companies work with the MobleyMD practice. If you have an insurance that does not work with our practice then, the good news is that you still have several options to receive the best possible care.

First, your health insurance may have an “out of network” option. When you see Dr. Mobley out of network you will likely share in a greater financial responsibility for Dr. Mobley’s fees. However, many out of network options will still allow part or all of your anesthesia, lab, and OR fees to be covered more completely by your insurance company.

If you do not have out-of-network benefits, you may request that your insurance carrier allow you to be treated by Dr. Mobley under special circumstances because of his unique regional and national expertise in surgically complex cases. Dr. Mobley’s primary professional interest is to help restore patients with more normal nasal function & facial appearance. Our practice will consider adjusting fees based on the complexity of the case. Please know that during your consultation we can discuss your personal situation in more detail to find a solution that works for you.

Frequently Asked Questions

BEFORE COMING TO YOUR APPOINTMENT:

HOW MUCH WILL MY INSURANCE SURGERY COST ME?

Because everyone’s issues can vary, we would first need to see you in consultation to determine the exact procedures Dr. Mobley would need to perform. Once we have the procedure codes (these are called CPT codes) then we start a pre-authorization process. If approved then we can assist you in determining what proportion of the final charges would be your responsibility.

Please remember that determining exact out of pocket costs for insurance can be very difficult. This is because everyone’s plan is just a bit different. Different plans have different deductibles and co-pay percentages required of the plan holder. Further, different plans have different out of pocket maximums that can vary as the fiscal year goes on. Also, recall that different insurance companies “allow” different charges for the same operation. We empathize that it can be quite difficult to get an exact amount; but do know that our staff will do our very best to empower you with the best, most accurate information we have. In the end, it is always best that you, the patient, talk directly with your insurance company to make sure you are fully aware of all of your potential financial responsibilities.

HOW LONG IS THE PRE-AUTHORIZATION PROCESS?

This can take anywhere from 2-6 weeks depending on variables such as what insurance you are with, how complex your surgery is, and how soon you need to have it performed. If we initially get a denial then the appeal process can take much longer than 6 weeks. Our office will advocate for you during the entire process. While we do not get every case approved, we are successful in the majority of our pre-authorizations. Each case is unique.

IS THERE ANYTHING I CAN DO TO HELP THE PRE-AUTHORIZATION PROCESS?

Yes, it is always very helpful for the patient to call on their behalf to get the approval. Often a letter/statement explaining the medical necessity in the words of you, the patient, can be very helpful. Remember, you are the customer to the insurance company. Very often, especially in more difficult to authorize cases, the involvement of the patient directly with the insurance company can be very helpful in obtaining authorization.

WHAT IF THEY DO NOT APPROVE THE SURGERY?

This is when the patient can start a member appeal. Dr. Mobley’s office can also start a provider appeal however this process can take up to 6 months where most insurance companies advise a member appeal can only take up to 90 days. If the appeal remains denied we can discuss a cash pay option and we are willing to submit your claim. Do keep in mind that insurance companies will often deny the claim making the payment the responsibility of the individual.