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The UCLA Division of Plastic & Reconstructive Surgery


Understanding Your Financial Obligation

Thank you for choosing UCLA Plastic Surgery as your specialty provider. The following information will help you understand your financial responsibilities. Should you have any questions, please do not hesitate to ask. Our staff is here to assist you.

Prior to Your First Appointment

Prior to the delivery of any care, all patients must complete a New Patient Packet, which includes a Billing Information Sheet and a Medical History Form. Whenever possible, we will mail these forms to you prior to your scheduled visit so that you may complete them at home.

Our New Patient Packet also includes a variety of authorizations and consent forms, which will allow us to share your information with our billing company and other care providers in accordance with HIPAA. Please read each authorization and consent form carefully before signing.

When signing in, please present your insurance card(s). If you belong to a managed care plan that requires a written authorization, please submit your authorization along with your insurance card.

While our in-network providers participate in many managed care plans, it is your responsibility to verify that your plan includes our physician and that you have a valid referral.

If you plan to receive care from an out-of-network provider, please review the terms of your plan's out-of-network coverage. Most plans require participants to pay a greater portion of the fees when receiving out-of-network services.

Insurance Coverage

The most common misconception regarding insurance is that your policy will cover the total cost of your care. Insurance is designed to reduce your out-of-pocket costs, but it will not eliminate them entirely.

Your care should not and will not be dictated based on your insurance coverage. Your physician will develop a treatment plan based on your current medical needs. We cannot limit your surgical care to just the procedures covered by your insurance plan. Every plan is different and each insurance company determines what procedures they will cover.

Please understand that you will be liable for the full cost of procedures and treatments not covered by your insurance.  Payment is due at the time of service.

Commercial Insurance (also known as indemnity, regular insurance, or insurance)

You are responsible for payment of the patient's portion for all office visits, office procedures, surgeon's fees, and other charges. Payment is due on the date of your office visit or during your pre-op appointment.

Our staff will call your insurance company ahead of time to determine your deductible and the percentage of fees your plan assigns to you for payment.

HMO & PPO Plans (In-Network)

You are responsible for payment of all co-pays and deductibles on the date of service. If you undergo a procedure not covered by your plan, payment in full will be requested on the date of service.

Our staff will contact your insurance company to determine your co-pay and / or deductible, and verify which procedures your plan will cover.

HMO, Point-of-Service, and PPO Plans (Out-of-Network)

You are responsible for the full cost of your medical care. Your insurance company will reimburse you a percentage based on the terms of your policy. Your out-of-pocket expense represents the full cost of your care minus the amount reimbursed by your insurance company. Payment is due on the date of service for all procedures and office visits. The patient portion of surgeon's fees is due on the day of your pre-op consultation. You will be responsible for the full cost of treatments or procedures not covered by your plan.

Our staff will file an insurance claim on your behalf. Most plans require you to pay the full fee in advance and will then reimburse you directly. For your convenience, we will only collect the patient portion, however please remit any payments sent directly to you by your insurance company. If we do not receive these payments in a timely fashion, you will be billed for the unpaid balance.


If you have regular Medicare and have not met your $155 deductible, we ask that it be paid at the time of service. You are responsible for the full cost of any services not covered by Medicare and we ask that you pay in full at the time of service.

If you have Medicare as your primary insurance and also have secondary insurance, no payment is necessary. If you have Medicare as your primary insurance with no secondary service, you will be asked to pay your 20% co-pay at the time of service.

Cash-Pay (No Insurance)

You are responsible for the full cost of all treatments and procedures. Payment is due on the day of your office visit or during your pre-op appointment.


We accept cash, checks, Visa, Mastercard, American Express and Discover card.



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