Insurance “Re-direct”

drgelman — Mon, 27 Feb 2012 03:51:16 +0000

Over the years, many patients have been referred to our Center, often by their local Urologists. In some cases, we are then informed by the insurance companies that a patient is being “re-directed” to another doctor within their network. In general, the doctor is not exclusively specialized in male reconstruction such as urethral stricture surgery. When this happens, if the doctor indicates he-she has some expertise with the needed surgery and is “comfortable” doing the surgery, then there is no obligation of the insurance to authorize care at our institution. The problem we have noticed is that patients then have surgery elsewhere with a very bad outcome. Then, the insurance often approves for the patient to receive care for the re-do surgery at our center. Although no doctor can ever guarantee a successful outcome, and a failure is not always due to a technical problem during surgery, I wish reimbursement would be based on the technical outcome as then, doctors who have a high failure rate will not be financially rewarded. What is most frustrating is that even after we successfully cure patients who have had failed surgery after being initially re-directed, subsequent patients continue to be re-directed, often to the same doctors who continue to accept the patients. When patients are re-directed, they should understand that the motivation of the insurance to save money (even though when a 2nd surgery is needed, money is not saved), and when there is a bad outcome due to poor technique, the insurance will never even say “I am sorry”. I would encourage patients who are re-directed to carefully research the doctor’s expertise. I believe the best way to see if a doctor is specialized is to look him-her up and determine the scope of the practice. The more things a doctor does, the less that doctor is specialized in anything in particular. I am not suggesting that a doctor has to be specialized in male urethral-genital reconstruction to do this surgery. However, when we successfully repeatedly succeed in re-do surgery, I know that I would have very likely succeeded with the initial easier surgery if I would have been given the opportunity, not because I am a better surgeon, but because I am more experienced at that particular surgery.

Center for Reconstructive Urology

admin — Fri, 13 Jan 2012 00:31:08 +0000

We are a regional, national, and international tertiary referral center dedicated to the treatment of disorders of the male urethra and external genitalia. In addition to patient care, our mission includes clinical and laboratory research and teaching.

Diseases treated include urethral stricture disease, curvature of the penis from Peyronie’s disease and other causes, erectile dysfunction, also called ED and impotence, including penile prosthesis (also called a penile implant) placement or revision, hypospadias, complications from prostate cancer treatment with radiation or surgery, and other disorders of the male external genitalia.

Dr. Joel Gelman, the Director of the Center for Reconstructive Urology, and Associate Clinical Professor of Urology at the University of California, Irvine is a leading expert in male urethral and penile reconstructive surgery. Dr. Gelman is fellowship trained and his practice is exclusively devoted to surgery of the male urethra and external genitalia. He has performed over 700 reconstructive surgeries. Over 200 Urologists have referred their patients to Dr. Gelman when their patients have required complex urethral or penile surgery. Although the vast majority of our patients are referred by their local Urologists, we also accept new patients.

In addition to specific information about the care we provide to our patients at the Center for Reconstructive Urology, this website contains detailed educational information in the Conditions Treated section. By clicking on the “Conditions Treated” tab (or selecting a specific condition from the choices on the left), you can learn about the causes, symptoms, tests used to make a diagnosis, and the treatment options for urethral stricture disease, including urethroplasty (surgery to repair or reconstruct the urethra), Peyronie’s Disease, Erectile Dysfunction, Hypospadias, Prostate Cancer Treatment Complications, Male Incontinence, and other male urethral and genital disorders including rare diseases such as Lichen Sclerosis – Scleroses, also known as Balanitis Xerotica Oblitarans or BXO, Lymphedema, and Hidradenitis. In summary, our Center is exclusively specialized in the treatment of disorders of the male urethra, penis, and external genitalia.

All services are provided at the UC, Irvine Medical Center located in Orange, California. However, The Center For Reconstructive Urology is a professional practice separate and independent from the UCI Medical Center and Medical Group.

The Center for Reconstructive Urology

Insurance “Re-direct”

Center for Reconstructive Urology