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Gender Health SF


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Gender Affirming Surgery Access & Services


Gender Health SF GAS Flow


*UPDATED JUNE 2021*

For Primary Care Providers: How to make a surgery referral or ask a consult question

 

Patient’s primary care provider submits an e-Consult in Epic (or via CareLink for SFCCC clinics). The Gender Health SF e-Consult can be found by typing “transgender” into the Orders function within a patient chart.


Using this e-Consult, you can do 3 things:

  1. Ask a clinical consultation question pertaining to gender affirming care, including hormone therapy.
  2. Make a complete surgery referral for patients with Full Scope Medi-cal, Medicare A&B, San Francisco Health Plan (including Healthy Workers and Healthy Families) with SF Health Network medical group, or Healthy San Francisco.
    1. Make a complete surgery referral for patients with Full Scope Medi-cal, Medicare A&B, San Francisco Health Plan (including Healthy Workers and Healthy Families) with SF Health Network medical group, or Healthy San Francisco.
  3. Refer any patient in our system of care who is seeking gender affirming surgery for Peer Navigation services. For patients who have Anthem BC Medi-Cal, the PCP simultaneously submits the surgery referral directly to the selected surgeon’s office; GHSF does not process the surgery referrals themselves.

Please see Insurance & Health Benefits Matrix for more information about surgical coverage & benefits referral process

 

Key points for successful surgery referral submission:

  • All referrals & supporting documents must be made through Epic or CareLink. Please do not fax or email surgery referrals or supporting documents as they will not be processed.
  • Necessary documents for a complete referral include: e-Consult and all questions answered, recent progress note and H&P, and pre-surgical assessment(s) that correlate with surgery(ies) referred for.
  • Prior to submitting an e-Consult for surgery, ensure that patient has completed the required Pre-Surgical Assessment(s) (PSA) with a licensed mental health provider(s) and document(s) are scanned into the patient chart under Media in Epic; only referrals with the necessary documents listed above in the chart will be accepted as complete. Incomplete referrals will be returned to PCP with instructions for completion.
  • We no longer require a separate Med Eval form or signed patient education forms; this content is now addressed within the e-Consult questions themselves.

 

Hair Reduction

All facial and body hair reduction requests for electrolysis or laser are completed by PCP clinic. Pre-authorizations are sent directly to patient’s insurance plan for approval.


Behavioral Health: Pre-Surgical Assessments

Gender Health SF’s presurgical assessment (PSA) is designed to cover both insurance approval needs by focusing on medical necessity and best outcomes for patients by focusing on informed consent, stability and readiness for surgery. The PSA needs to be completed and sent to the primary care provider prior to referral submission. The PSA is based on WPATH SOC7. The PSA (or a comparable letter) needs to be completed by a licensed mental health provider (or associate mental health providers co-signed by a licensed provider who has also met with the patient.) . See Clinical Resources for more information and links to the presurgical assessment forms.

 

Gender Health SF Services

Patient focus:

  • Peer Led Navigation
  • Gender Affirming Surgery Education, Preparation, Planning (EPPs)
  • Gender Affirming Surgery Care Coordination
  • Patient Wellness
  • Support Groups
    • Post-op Vaginoplasty Group: Please contact mainline for more information
      • In English 2nd Wednesday of the Month (5-6:30 pm via Zoom)
      • In Spanish 4th Wednesday of the Month (5-6:30 pm via Zoom)

Clinician and system focus:

  • Clinical Consultations
  • Provider Trainings
  • Capacity building
  • Transgender and Nonbinary workforce development

 

 

Gender Health SF
San Francisco Department of Public Health
628.206.7979 Main Line | 629.206.7999 Fax
Email Us