Do I have to have an in-person office visit before I can schedule surgery?

Lesion Excision Surgery

Except for malignant melanoma which requires an in-person evaluation, you have 3 options for evaluation for a possible lesion excision:

1. Schedule an in-person office visit/consultation. At this visit, the lesion will be evaluated and treatment options discussed but no surgical procedure will be performed. Surgery will take place on another date of service. You will be responsible for any office co-pays/co-insurance required by your insurance plan.
2. Schedule an online visit. This requires you to have a cell phone, computer, or tablet with internet connectivity, a camera, a microphone and some technical ability. A link will be sent to your email address allowing you to open a secure patient visit online. Just like an in-person visit, you will be responsible for any co-pays/co-insurance required by your insurance plan. Although we try to keep these appointments on schedule this is not always possible and we recommend you leave a minimum of one hour available following your scheduled appointment time.
3. Upload photos of the lesion(s) and other pertinent information to our office. This is a no-cost option. Go to the “Contact Us” tab on this website and follow the instructions for uploading your photos. Dr. Fremling will review the photos and we will provide you with an estimate for your procedure. There is no co-pay/co-insurance due for this estimate since this is not an office visit or online visit. Because this is not a formal evaluation, it does not establish a doctor-patient relationship and Dr. Fremling will not provide any medical recommendations about whether a lesion should or should not be excised. This option only provides an estimate for patients who have already decided that they wish to have a lesion excised.

Hand Surgery
At the present time we require all patients to be evaluated in person prior to scheduling hand surgery except those seeking treatment for mucous cysts of the fingers. Surgery will not be performed at the initial visit. Even if you have been evaluated by another physician who has recommended operative treatment, there are a number of issues that must be resolved before hand surgery can be scheduled.

• Is surgery actually needed?
• How much time will be required to perform the surgery?
• Where will the surgery take place…office vs surgery center?
• What type of anesthesia will be needed?
• Are there any medical issues that may impact a surgical procedure?
• Are there any medications that may impact a surgical procedure?

Additionally, we attempt to obtain preauthorization prior to any scheduled surgical intervention and most insurance companies will not preauthorize a hand procedure if the patient has not been evaluated by the surgeon requesting preauthorization.