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Los Angeles | Beverly Hills

Bad Doctor – Patient Insurance Cases

Dr. Kenneth Hughes of Hughes Plastic Surgery in Los Angeles has performed his fair share of insurance-related cases, though he stopped performing those cases several years ago.  Most plastic surgeons practice within a pretty narrow range of the plastic surgery specialty.  Dr. Kenneth Hughes has performed reconstructive hand and facial surgery as well as reconstructive breast surgery and post traumatic deformity surgeries. Though some insurances will pay for cosmetic improvement in reconstructive situations, there are many cases in which medical insurance will not cover such procedures.

This can be particularly harmful to needy patients as these procedures may be necessary in helping restore self image and a good positive outlook on life. Although more costly for some patients, many patients will elect to pay out of pocket for an elite plastic surgeon who creates the results that they desire or practices in a way that they feel comfortable.

On the opposite side, patient medical insurance can be more trouble than it is worth for doctor’s offices. Insurance claims can take months to years to be approved and can pit doctor against patient when the monies are finally parcelled out sometimes years later. Checks may be sent from the insurance companies to the patients instead of the doctors. Doctors’ offices are then compelled to track down the payment and demand payment from the patient. This can create an adversarial relationship and can lead to a breakdown in the doctor patient relationship.  This can lead to lawsuits or threats of lawsuit for malpractice or negligence.  For the doctor’s part, some doctor’s office may have to remind patients that cashing a check for a doctor’s services is tantamount to fraud.

This bad relationship can develop for many reasons that have absolutely nothing to do with surgical results. It is important to realize what factors can be at play so that the doctor and the patient can feel comfortable in what can be a struggle with insurance companies.

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