Prior Authorization for Functional Plastic Surgery

ConsultStar provides prior authorization support for functional plastic surgery practices. Many procedures in this specialty require clear documentation of medical necessity, particularly when payers distinguish between functional and cosmetic indications.

We manage the authorization process so your team can focus on clinical care, reviewing documentation and helping submissions meet payer criteria.

Common Functional Plastic Surgery Procedures We Support

• Breast reconstruction

• Skin cancer reconstruction

• Scar revision with functional impairment

• Hand and extremity reconstruction

• Other reconstructive procedures requiring authorization

How We Help

• Review clinical notes and operative reports for payer-specific requirements

• Prepare and submit authorization requests with supporting documentation

• Track status and coordinate follow-up or additional information requests

• Assist practices using AI tools within their EHR by refining documentation drafts for completeness and accuracy

Key Facts

• Experience with functional versus cosmetic medical necessity distinctions

• On-shore support across commercial payers

• Per-transaction pricing — pay only for authorizations handled

• Review and refinement of AI-generated documentation for payer compliance

We work with commercial payers and other plans commonly seen in functional plastic surgery. Contact us to discuss your practice’s prior authorization needs.