Paul MittermillerDr

Dr. Mittermiller himself has not been a concern. My complaint is about the communication and transparency of the office. I’m currently waiting for a surgery date. I have been waiting over 3 months as of completing all of my items. My consult was in December of 2023. I cleared my pre surgical items at the beginning of February of 2025. Here’s the thing: I initially had several problems completing my items because of difficulty with office staff. The first major barrier was insurance. I was instructed that my private insurance and Medicare (that I have because of legal blindness) was not going to work because they can’t bill private insurance first. Because i don’t specialize in billing, I went through the process of trying to drop Medicare. This process can include penalties when reapplying in retirement but also require repaying all benefits previously received. What I later learned was that the Align office didn’t know how to bill my private insurance as the primary. I had to insist that they call Medicare’s provider line and learn how to do this. The next issue I ran into was needing to send several copies of my CT scan because the office couldn’t determine how to open it. Again, I had to insist on someone from the hospital’s imaging team explain it over the phone. This was essentially a fortunate personal favor because I knew someone in the imaging department. The third problem that came up was the requirement for me to get clearance from a geneticist. I did this, had the consult notes sent, but couldn’t get office staff at Align to relay my request to forgo the $998 genetic test when it wasn’t recommended. Because of delays with Align communication, I chose to do the test in hopes that insurance would cover it. It was only at this point did I learn that I wouldn’t need the test. I’m now needing to finance this because insurance didn’t cover it. And lastly, my main complaint is with scheduling. There was no social media post, phone call, email, etc. for weeks during the wildfires in January. When I finally got cleared, I continued to not hear from the office for weeks at a time. It wasn’t until March that I began emailing the joint email for both locations in an attempt to get someone in LA to answer the phone, return a voicemail, or reply to an email. I was finally told the extent of scheduling barriers, and I was assured I’d get biweekly updates. I don’t get biweekly updates. I don’t get any updates. Instead, I found out mid March that some patients are being asked to try having a single case agreement done for an out of network facility due to the current contracted hospital for private insurance patients not making OR time available. I got that update from other patients in a private Discord. No one at Align ever reached out to inform me that this was even an option. I tried reaching out about whether this is what I should expect. Nothing. Finally, I emailed to just request a surgery date at that alternate facility. I did get a response about it on 4/9/25. Nothing since. It’s now 5/13/25. No prior authorization was sent for that facility by Align. I checked again before posting this. I don’t know what to do. This is incredibly demoralizing and I’ve started to feel hopeless about trying to communicate with office staff. Although I think Dr. Mittermiller cares, the office is creating so much additional stress by impaired communication that it’s impacting my well-being. I’m finding that I’m having trouble sleeping at night and focusing at work due to the stress of these communication barriers. I know my surgical plan will be expensive, but I can’t properly budget for real current needs because of how little I know about scheduling. I would recommend Dr. Mittermiller but I can’t recommend Align’s LA office while it’s so difficult to communicate with them consistently. There’s no clear way to address these complaints with Align beyond directly bringing them up with the staff involved, so that’s what has led me to a review. I suppose the next step may be a grievance with my insurance.

Dr. Mittermiller and his team were excellent in their care! They answered all of my questions and helped me hone in on a plan for my procedures. Dr. Mittermiller's use of Photoshop helped greatly to visualize potential changes (with the caveat of the limitations of surgery vs. Photoshop which was also clearly explained). I am excited to continue working with them in the future!

Dr Michael Safir is my surgeon I recently switched teams and honestly I couldn’t ask for better . I came to him with my concerns about my old surgeons bed side manner and explained why our relationship was cut short just hoping he would be different. He honestly made me his priority after I started having complications he kept me in the loop and was on standby unlike my old surgeon who brushed me away when I felt like something was an emergency. Dr Safir made it his priority so much I ended up with a stricture that was bad to the point I was only dribbling and barely emptying my bladder. He had clinic this day so his shifted ended at 5pm, he ended up meeting me in the er right after getting off just to do an emergency procedure on me . My old surgeon would’ve brushed it off honestly as long as something was coming out he wouldn’t care. I ended up getting sent home the next day he called me the day I was sent home and the morning after that “ Hey Dion’Dre I’m sorry to wake up it’s 7:30 and I have to go in the OR soon I just wanted to check on you make sure you are doing fine and that you got your medicine. I say this to say it’s the little things that matter honestly he’s very caring it’s rare to find surgeons like him who’s not just here for money. My old surgeon wouldn’t do the things he does he answers quick when needed I just regret not choosing him to begin with!

Affirming Experience with Dr. Paul Mittermiller Meeting Dr. Paul Mittermiller and being his patient has been an incredibly professional, welcoming, and supportive experience. He and the Align Surgical Association team are deeply committed to serving the transgender community with care and expertise. Their dedication makes me feel truly valued, respected, and grateful.

Excellent experience throughout my 2 FFS procedures. Dr Mittermiller always took time to take care of me. I never felt rushed. Align staff was also extremely helpful and responsive through Email or Call. I look forward to my round 3 (: