What does it mean to be fellowship trained?

All Urologists complete a 5-6 year Residency after Medical School. During Residency, those pursuing a career in the specialty of Urology are exposed to all aspects of Urology including disorders of the prostate (prostate cancer, prostate enlargement), the ureters, the bladder (bladder cancer and other disorders), kidney cancers, kidney stones, female incontinence, pediatric urology, urethral disorders, sexual dysfunction, renal transplantation, testicular disorder (eg. cancer, torsion), laparoscopic and robotic surgery, adrenal discorders, and other diseases of the urinary and male genital tract.

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 Felloswhips. 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.

What does it mean to be specialized in male urethral and penile urethral reconstructive surgery?

All Urologists are “specialized” in all aspects of Urology. This means that their practice does not involve the brain, the lungs, the heart, or other body systems and is instead limited to diseases of the urinary and male genital tract. Some Urologists focus on one or more aspects of Urology without first completing a formal fellowship. Others may specialize in Pediatric Urology or Female Urology or have General Urology practices, but include male reconstructive surgery as part of their practice.

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.

Does Dr. Gelman treat children with hypospadias and urethral strictures?

Yes. Dr. Gelman is fellowship training in both adult and pediatric urethral reconstructive surgery. This training included the treatment of hypospadias a congenital disorder associated with improper development of the urethra. However, Dr. Gelman does not frequently perform routine initial hypospadias surgery. Most boys born with hypospadias are diagnosed by their Pediatricians and then referred to their local Pediatric Urologist for surgical treatment. This is appropriate as most Pediatric Urologists are well qualified to perform hypospadias surgery. Pediatric patients who are referred to our Center generally are referred for treatment of complex urethral strictures or other complications of prior hypospadias surgery, or the management of urethral trauma, such as pelvic fracture or straddle trauma related injuries to the urethra.

Are you able to make special accommodations for patients who do not live in Southern California?

Many of our patients travel to our Center for care from all areas of California, other states across the country, and even other countries such as the Netherlands, Thailand, Saipan, and El Salvador. All patients are contacted by Dr. Gelman in advance so that any testing that is indicated can be performed at the time of initial consultation. There are several hotels adjacent to the UC, Irvine Medical Center that offer discounts to patients who receive care at UC, Irvine. Patients are provided with written documentation to assist in the planning of travel.

Do you accept my insurance?

That depends on the definition of “accept”. When patients are referred to our Center and have HMO coverage, we are often able to obtain authorization and a letter of agreement to provide care. The patient then has complete coverage for all services, except perhaps for a co-pay, often less than $20. Patients are not “balance billed”.

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.