Guest guest Posted June 26, 2003 Report Share Posted June 26, 2003 I had United Healthcare when this all began and they covered part of the braces. We changed insurance midway and the new insurance would not cover braces if you were over 25. > hi everyone, > > just out of curiosity, has any of your braces been covered by > insurance. because assuming, that the insurace covers the jaw > surgery, they should cover the braces too, since it's a necessity > for the surgery. thanks! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 26, 2003 Report Share Posted June 26, 2003 I had United Healthcare when this all began and they covered part of the braces. We changed insurance midway and the new insurance would not cover braces if you were over 25. > hi everyone, > > just out of curiosity, has any of your braces been covered by > insurance. because assuming, that the insurace covers the jaw > surgery, they should cover the braces too, since it's a necessity > for the surgery. thanks! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 26, 2003 Report Share Posted June 26, 2003 Hello to all, I am still somewhat new to this site. There is a lot of great info provided by all of you to help each other. I have had problems getting my ins. to prior auth the surgery. My appeal process has started today so I am asking for any crossed fingers and/or prayers to go my way for a good outcome to this very frustrating and tiring process. It has felt like my life has been in a " holding " pattern. I know that so many of you have been or are going through this very same situation. Thank you for listening, a Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2003 Report Share Posted July 4, 2003 Hi, The only thing I can think of is that the opposite of objective is biased, isn't it? Is maybe the surgeon your Mom or something?! Sorry, lame attempt to make you smile. I don't have much knowledge in the way of insurance. I was diagnosed with TMJ and haven't, so far thank God, had any troubles getting approval with what my Surgeon has requested. I'd say ask a lot of questions, once the holiday has passed, and don't give up. Appeal if you have to. From what I've read on this site, lots of folks have had great results from the appeal process. Best of luck!!! Carol > I received a notice of adverse determination last week. It said that > there is no objective documentation of a physical impairment that > would be improved or removed by the procedures submitted. Therefore, > it is considered cosmetic. I've been so busy and I finally got a > chance to call the surgeons office today and all she said was them a > copy. I kind of felt blown off. I didn't expect much more than that > the day before the 4th of July. I faxed one but I am not sure what > they are going to do with it they should of already got a copy from > my insurance company. The insurance company was not exactly > helpful. I was just wondering if anyone has seen anything like this > before. Any ideas of what objective documentation is ? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2003 Report Share Posted July 4, 2003 Hi, The only thing I can think of is that the opposite of objective is biased, isn't it? Is maybe the surgeon your Mom or something?! Sorry, lame attempt to make you smile. I don't have much knowledge in the way of insurance. I was diagnosed with TMJ and haven't, so far thank God, had any troubles getting approval with what my Surgeon has requested. I'd say ask a lot of questions, once the holiday has passed, and don't give up. Appeal if you have to. From what I've read on this site, lots of folks have had great results from the appeal process. Best of luck!!! Carol > I received a notice of adverse determination last week. It said that > there is no objective documentation of a physical impairment that > would be improved or removed by the procedures submitted. Therefore, > it is considered cosmetic. I've been so busy and I finally got a > chance to call the surgeons office today and all she said was them a > copy. I kind of felt blown off. I didn't expect much more than that > the day before the 4th of July. I faxed one but I am not sure what > they are going to do with it they should of already got a copy from > my insurance company. The insurance company was not exactly > helpful. I was just wondering if anyone has seen anything like this > before. Any ideas of what objective documentation is ? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2003 Report Share Posted July 4, 2003 Hi, The only thing I can think of is that the opposite of objective is biased, isn't it? Is maybe the surgeon your Mom or something?! Sorry, lame attempt to make you smile. I don't have much knowledge in the way of insurance. I was diagnosed with TMJ and haven't, so far thank God, had any troubles getting approval with what my Surgeon has requested. I'd say ask a lot of questions, once the holiday has passed, and don't give up. Appeal if you have to. From what I've read on this site, lots of folks have had great results from the appeal process. Best of luck!!! Carol > I received a notice of adverse determination last week. It said that > there is no objective documentation of a physical impairment that > would be improved or removed by the procedures submitted. Therefore, > it is considered cosmetic. I've been so busy and I finally got a > chance to call the surgeons office today and all she said was them a > copy. I kind of felt blown off. I didn't expect much more than that > the day before the 4th of July. I faxed one but I am not sure what > they are going to do with it they should of already got a copy from > my insurance company. The insurance company was not exactly > helpful. I was just wondering if anyone has seen anything like this > before. Any ideas of what objective documentation is ? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2003 Report Share Posted July 4, 2003 Objective documentation is things like x-rays, models, and cephalometric traces (I have no idea what that last one is, I just know that for my latest denial my insurance company said I didn't submit any). My doctor also submitted the operative notes (I wasn't pre- authorized) but I still got denied. --Neil > I received a notice of adverse determination last week. It said that > there is no objective documentation of a physical impairment that > would be improved or removed by the procedures submitted. Therefore, > it is considered cosmetic. I've been so busy and I finally got a > chance to call the surgeons office today and all she said was them a > copy. I kind of felt blown off. I didn't expect much more than that > the day before the 4th of July. I faxed one but I am not sure what > they are going to do with it they should of already got a copy from > my insurance company. The insurance company was not exactly > helpful. I was just wondering if anyone has seen anything like this > before. Any ideas of what objective documentation is ? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2003 Report Share Posted July 4, 2003 Objective documentation is things like x-rays, models, and cephalometric traces (I have no idea what that last one is, I just know that for my latest denial my insurance company said I didn't submit any). My doctor also submitted the operative notes (I wasn't pre- authorized) but I still got denied. --Neil > I received a notice of adverse determination last week. It said that > there is no objective documentation of a physical impairment that > would be improved or removed by the procedures submitted. Therefore, > it is considered cosmetic. I've been so busy and I finally got a > chance to call the surgeons office today and all she said was them a > copy. I kind of felt blown off. I didn't expect much more than that > the day before the 4th of July. I faxed one but I am not sure what > they are going to do with it they should of already got a copy from > my insurance company. The insurance company was not exactly > helpful. I was just wondering if anyone has seen anything like this > before. Any ideas of what objective documentation is ? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2003 Report Share Posted July 4, 2003 Objective documentation is things like x-rays, models, and cephalometric traces (I have no idea what that last one is, I just know that for my latest denial my insurance company said I didn't submit any). My doctor also submitted the operative notes (I wasn't pre- authorized) but I still got denied. --Neil > I received a notice of adverse determination last week. It said that > there is no objective documentation of a physical impairment that > would be improved or removed by the procedures submitted. Therefore, > it is considered cosmetic. I've been so busy and I finally got a > chance to call the surgeons office today and all she said was them a > copy. I kind of felt blown off. I didn't expect much more than that > the day before the 4th of July. I faxed one but I am not sure what > they are going to do with it they should of already got a copy from > my insurance company. The insurance company was not exactly > helpful. I was just wondering if anyone has seen anything like this > before. Any ideas of what objective documentation is ? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2003 Report Share Posted July 4, 2003 Thank you. Atleast it is something. I was worried that they just made it up. lol > > I received a notice of adverse determination last week. It said > that > > there is no objective documentation of a physical impairment that > > would be improved or removed by the procedures submitted. > Therefore, > > it is considered cosmetic. I've been so busy and I finally got a > > chance to call the surgeons office today and all she said was them > a > > copy. I kind of felt blown off. I didn't expect much more than > that > > the day before the 4th of July. I faxed one but I am not sure what > > they are going to do with it they should of already got a copy from > > my insurance company. The insurance company was not exactly > > helpful. I was just wondering if anyone has seen anything like > this > > before. Any ideas of what objective documentation is ? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2003 Report Share Posted July 4, 2003 Thank you. Atleast it is something. I was worried that they just made it up. lol > > I received a notice of adverse determination last week. It said > that > > there is no objective documentation of a physical impairment that > > would be improved or removed by the procedures submitted. > Therefore, > > it is considered cosmetic. I've been so busy and I finally got a > > chance to call the surgeons office today and all she said was them > a > > copy. I kind of felt blown off. I didn't expect much more than > that > > the day before the 4th of July. I faxed one but I am not sure what > > they are going to do with it they should of already got a copy from > > my insurance company. The insurance company was not exactly > > helpful. I was just wondering if anyone has seen anything like > this > > before. Any ideas of what objective documentation is ? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2003 Report Share Posted July 4, 2003 Thank you. Atleast it is something. I was worried that they just made it up. lol > > I received a notice of adverse determination last week. It said > that > > there is no objective documentation of a physical impairment that > > would be improved or removed by the procedures submitted. > Therefore, > > it is considered cosmetic. I've been so busy and I finally got a > > chance to call the surgeons office today and all she said was them > a > > copy. I kind of felt blown off. I didn't expect much more than > that > > the day before the 4th of July. I faxed one but I am not sure what > > they are going to do with it they should of already got a copy from > > my insurance company. The insurance company was not exactly > > helpful. I was just wondering if anyone has seen anything like > this > > before. Any ideas of what objective documentation is ? Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.