Subsequent to Residency training, some Urologists pursue sub-specialty training called a Fellowship where they focus on one particular area of Urology. Examples include Oncology and Pediatric Urology, and Female Urology Fellowships. Other Fellowships offer a more broad exposure to different areas of Urology, but in doing so, provide less exposure to a particular disease process.
Dr. Gelman completed a formal Fellowship exclusively devoted in male urethral and penile reconstructive surgery. Currently, there are now an abundance of doctors indicating that they are Fellowship trained. However, this designation no longer has the same meaning as it once did as there are a number of Fellowships that include male reconstructive surgeries as a minor component of training. Moreover, it is common for those who do not gain acceptance into a recognized training program to work with an individual after residency and then indicate this represents Fellowship training.
Dr. Gelman’s practice is exclusively devoted to male urethral and penile reconstructive surgery. It is Dr. Gelman’s experience and belief that he can best perform urethral stricture and Peyronie’s disease surgery, and other surgeries of the male urethra and external genitalia if his practice is exclusively limited to these areas of Urology. The most effective way to determine if someone has expertise associated with exclusive specialization is not to ask the doctor “how many X surgeries have you performed?” but rather, see if that doctor lists many other interests or has reviews associated with the treatment of unrelated conditions.
When patients have PPO insurance, coverage can vary depending on the benefits provided by the plan. When patients are scheduled for a consultation, procedures, followup visits, and/or surgery, we first contact the insurance carrier to determine benefits. However we can not be responsible for what the carrier will cover as this is beyond our control. Patients are always provided with an estimate of the charges. In some cases, PPO insurance covers all charges. However, it is often the case that the patient is responsible for a portion of the charges. We are usually unable to inform our patients exactly what an insurance carrier will pay, because when we inquire, we are informed that benefits are determined after a claim is submitted. In other words, the insurance carrier will not determine the amount covered until after the service is performed. In most cases, benefits include coverage of a percentage of “usual and customary” charges, but most PPO carriers will not say in advance what they consider usual or customary for a given service. When payment is a low amount, we routinely appeal. When surgeries are performed, we always submit the typed detailed operative dictation providing justification for the billed amount. We never collect in advance and then ask the patient to submit billing to their carrier to seek reimbursement. When patients have a high balance after insurance payment , we often offer payment plans so that patients who want to receive care at our Center are not discouraged for financial reasons.