Re: How long after ins. co approval were you scheduled?

[Guest guest]

So long as the oral surgeon has been thorough in getting all the

information and materials deemed necessary to the insurance company,

it's not really in his hands anymore. It's the insurance company's

ball to play with now, and many are notoriously slow to approve jaw

surgeries.

On the bright side, I had a procedure not related to my jaw surgery

in mid September. I went in for my consultation, and then a week

later, I had to go back in for measurements. The doctor said that

the info the IC wanted had nothing to really do with determining the

medical necessity of the situation. Despite the delay from the

insurance company, I got my approval the next day after that second

visit, so once they had everything, they were pretty quick for me.

I can't speak to much in regards to the orhtognathic surgery and I

had to approach the whole thing backwards (my oral surgeon said I

needed the surgery and referred me to my ortho). All the material

for pre-approval was at the IC's office before I got my braces on.

Good luck to you. Perhaps it would be better to be a nuisance to the

insurance company.

> Hi Guys,

>

> I am supposed to be getting a maxillary osteotomy to reduce the

> excess bone and gum tissue in my upper jaw in January. My

insurance

> company is dragging their heels and now wants molds, xrays, etc. I

> absolutely have to get this done in January because my husbands

> employer won't pay for insurance after January (he's on Cobra). I

> was just wondering how long it was after getting the pre-

> certification that you got the surgery done. My oral surgeon's

> office won't even schedule the surgery until I have the pre-

> certification. So, I am really freaking out here. I only have

like

> 6 weeks until January is over, so I am *really* running out of time!

>

> Is there anything I can do to speed up the certification process?

> (short of being an extreme nuisance to my oral surgeon)

>

> Thanks

>

[Guest guest]

So long as the oral surgeon has been thorough in getting all the

information and materials deemed necessary to the insurance company,

it's not really in his hands anymore. It's the insurance company's

ball to play with now, and many are notoriously slow to approve jaw

surgeries.

On the bright side, I had a procedure not related to my jaw surgery

in mid September. I went in for my consultation, and then a week

later, I had to go back in for measurements. The doctor said that

the info the IC wanted had nothing to really do with determining the

medical necessity of the situation. Despite the delay from the

insurance company, I got my approval the next day after that second

visit, so once they had everything, they were pretty quick for me.

I can't speak to much in regards to the orhtognathic surgery and I

had to approach the whole thing backwards (my oral surgeon said I

needed the surgery and referred me to my ortho). All the material

for pre-approval was at the IC's office before I got my braces on.

Good luck to you. Perhaps it would be better to be a nuisance to the

insurance company.

> Hi Guys,

>

> I am supposed to be getting a maxillary osteotomy to reduce the

> excess bone and gum tissue in my upper jaw in January. My

insurance

> company is dragging their heels and now wants molds, xrays, etc. I

> absolutely have to get this done in January because my husbands

> employer won't pay for insurance after January (he's on Cobra). I

> was just wondering how long it was after getting the pre-

> certification that you got the surgery done. My oral surgeon's

> office won't even schedule the surgery until I have the pre-

> certification. So, I am really freaking out here. I only have

like

> 6 weeks until January is over, so I am *really* running out of time!

>

> Is there anything I can do to speed up the certification process?

> (short of being an extreme nuisance to my oral surgeon)

>

> Thanks

>

[Guest guest]

So long as the oral surgeon has been thorough in getting all the

information and materials deemed necessary to the insurance company,

it's not really in his hands anymore. It's the insurance company's

ball to play with now, and many are notoriously slow to approve jaw

surgeries.

On the bright side, I had a procedure not related to my jaw surgery

in mid September. I went in for my consultation, and then a week

later, I had to go back in for measurements. The doctor said that

the info the IC wanted had nothing to really do with determining the

medical necessity of the situation. Despite the delay from the

insurance company, I got my approval the next day after that second

visit, so once they had everything, they were pretty quick for me.

I can't speak to much in regards to the orhtognathic surgery and I

had to approach the whole thing backwards (my oral surgeon said I

needed the surgery and referred me to my ortho). All the material

for pre-approval was at the IC's office before I got my braces on.

Good luck to you. Perhaps it would be better to be a nuisance to the

insurance company.

> Hi Guys,

>

> I am supposed to be getting a maxillary osteotomy to reduce the

> excess bone and gum tissue in my upper jaw in January. My

insurance

> company is dragging their heels and now wants molds, xrays, etc. I

> absolutely have to get this done in January because my husbands

> employer won't pay for insurance after January (he's on Cobra). I

> was just wondering how long it was after getting the pre-

> certification that you got the surgery done. My oral surgeon's

> office won't even schedule the surgery until I have the pre-

> certification. So, I am really freaking out here. I only have

like

> 6 weeks until January is over, so I am *really* running out of time!

>

> Is there anything I can do to speed up the certification process?

> (short of being an extreme nuisance to my oral surgeon)

>

> Thanks

>

[Guest guest]

Just be sure your surgeon's office is in communication with the

insurance office, and is providing whatever they've asked for.

I hate to be cynical and suspicious, but I swear I think some (but

not all -- mine did not) insurance companies drag their feet and try

to delay, hoping you'll give up and have the surgery without having

to pay.

Best I remember, my precert was good for six months, but a second one

was granted right away when my surgeon repplied for it. (I think my

surgeon did send pictures, x-rays and molds along with the request,

though, at least the first time around.)

Cammie

> Hi Guys,

>

> I am supposed to be getting a maxillary osteotomy to reduce the

> excess bone and gum tissue in my upper jaw in January. My

insurance

> company is dragging their heels and now wants molds, xrays, etc. I

> absolutely have to get this done in January because my husbands

> employer won't pay for insurance after January (he's on Cobra). I

> was just wondering how long it was after getting the pre-

> certification that you got the surgery done. My oral surgeon's

> office won't even schedule the surgery until I have the pre-

> certification. So, I am really freaking out here. I only have

like

> 6 weeks until January is over, so I am *really* running out of time!

>

> Is there anything I can do to speed up the certification process?

> (short of being an extreme nuisance to my oral surgeon)

>

> Thanks

>

[Guest guest]

Just be sure your surgeon's office is in communication with the

insurance office, and is providing whatever they've asked for.

I hate to be cynical and suspicious, but I swear I think some (but

not all -- mine did not) insurance companies drag their feet and try

to delay, hoping you'll give up and have the surgery without having

to pay.

Best I remember, my precert was good for six months, but a second one

was granted right away when my surgeon repplied for it. (I think my

surgeon did send pictures, x-rays and molds along with the request,

though, at least the first time around.)

Cammie

> Hi Guys,

>

> I am supposed to be getting a maxillary osteotomy to reduce the

> excess bone and gum tissue in my upper jaw in January. My

insurance

> company is dragging their heels and now wants molds, xrays, etc. I

> absolutely have to get this done in January because my husbands

> employer won't pay for insurance after January (he's on Cobra). I

> was just wondering how long it was after getting the pre-

> certification that you got the surgery done. My oral surgeon's

> office won't even schedule the surgery until I have the pre-

> certification. So, I am really freaking out here. I only have

like

> 6 weeks until January is over, so I am *really* running out of time!

>

> Is there anything I can do to speed up the certification process?

> (short of being an extreme nuisance to my oral surgeon)

>

> Thanks

>

[Guest guest]

Just be sure your surgeon's office is in communication with the

insurance office, and is providing whatever they've asked for.

I hate to be cynical and suspicious, but I swear I think some (but

not all -- mine did not) insurance companies drag their feet and try

to delay, hoping you'll give up and have the surgery without having

to pay.

Best I remember, my precert was good for six months, but a second one

was granted right away when my surgeon repplied for it. (I think my

surgeon did send pictures, x-rays and molds along with the request,

though, at least the first time around.)

Cammie

> Hi Guys,

>

> I am supposed to be getting a maxillary osteotomy to reduce the

> excess bone and gum tissue in my upper jaw in January. My

insurance

> company is dragging their heels and now wants molds, xrays, etc. I

> absolutely have to get this done in January because my husbands

> employer won't pay for insurance after January (he's on Cobra). I

> was just wondering how long it was after getting the pre-

> certification that you got the surgery done. My oral surgeon's

> office won't even schedule the surgery until I have the pre-

> certification. So, I am really freaking out here. I only have

like

> 6 weeks until January is over, so I am *really* running out of time!

>

> Is there anything I can do to speed up the certification process?

> (short of being an extreme nuisance to my oral surgeon)

>

> Thanks

>

[Guest guest]

After pre-cert is done, your surgery date will be a combination of

first availability for your surgeon and the hospital. A lot of

surgeons only do surgeries one day a week.

1) Call your insurance company and get a list of each item they need

to verify to approve your surgery.

2) Take that list to your OS and make sure they send each item to the

insurance company.

3) Follow-up with the insurance company and verify with them that

they received each item.

I would say 6 weeks is a tight timeline - but it can be done if all

the information is sent and received the first time.

My pre-cert and scheduling was very quick, but I'm sure that varies

by person and insurance carrier.

If you KNOW you have benefits, then you might also talk to your OS

about paying 1/2 the cost up-front so he'll schedule you. I think

the OS concern is that he won't get paid.

Hope that helps.

Kassandra

> Hi Guys,

>

> I am supposed to be getting a maxillary osteotomy to reduce the

> excess bone and gum tissue in my upper jaw in January. My

insurance

> company is dragging their heels and now wants molds, xrays, etc. I

> absolutely have to get this done in January because my husbands

> employer won't pay for insurance after January (he's on Cobra). I

> was just wondering how long it was after getting the pre-

> certification that you got the surgery done. My oral surgeon's

> office won't even schedule the surgery until I have the pre-

> certification. So, I am really freaking out here. I only have

like

> 6 weeks until January is over, so I am *really* running out of time!

>

> Is there anything I can do to speed up the certification process?

> (short of being an extreme nuisance to my oral surgeon)

>

> Thanks

>

[Guest guest]

After pre-cert is done, your surgery date will be a combination of

first availability for your surgeon and the hospital. A lot of

surgeons only do surgeries one day a week.

1) Call your insurance company and get a list of each item they need

to verify to approve your surgery.

2) Take that list to your OS and make sure they send each item to the

insurance company.

3) Follow-up with the insurance company and verify with them that

they received each item.

I would say 6 weeks is a tight timeline - but it can be done if all

the information is sent and received the first time.

My pre-cert and scheduling was very quick, but I'm sure that varies

by person and insurance carrier.

If you KNOW you have benefits, then you might also talk to your OS

about paying 1/2 the cost up-front so he'll schedule you. I think

the OS concern is that he won't get paid.

Hope that helps.

Kassandra

> Hi Guys,

>

> I am supposed to be getting a maxillary osteotomy to reduce the

> excess bone and gum tissue in my upper jaw in January. My

insurance

> company is dragging their heels and now wants molds, xrays, etc. I

> absolutely have to get this done in January because my husbands

> employer won't pay for insurance after January (he's on Cobra). I

> was just wondering how long it was after getting the pre-

> certification that you got the surgery done. My oral surgeon's

> office won't even schedule the surgery until I have the pre-

> certification. So, I am really freaking out here. I only have

like

> 6 weeks until January is over, so I am *really* running out of time!

>

> Is there anything I can do to speed up the certification process?

> (short of being an extreme nuisance to my oral surgeon)

>

> Thanks

>

[Guest guest]

Hi ,

I have Blue Cross and they approved my surgery within 3 days of

receiving all of the requisite information. That was on November

28. I called my OS right away because they knew I needed to have

surgery in December and I am now scheduled for lower jaw advancement

on Dec. 23. So - less than one month between approval and surgery.

However, the office staff for my OS had to rearrange some other

people's office visits so my surgeon could be available and they had

to make sure there was a a room at the hospital. So it seemed to

all work out for me, I was always upfront with the OS's staff about

the need to get it done soon after the insurance information went

through. But I too was worried up until the point when I made all

of the surgery appointments that time had already run out.

Good luck

Laurel

> Hi Guys,

>

> I am supposed to be getting a maxillary osteotomy to reduce the

> excess bone and gum tissue in my upper jaw in January. My

insurance

> company is dragging their heels and now wants molds, xrays, etc.

I

> absolutely have to get this done in January because my husbands

> employer won't pay for insurance after January (he's on Cobra). I

> was just wondering how long it was after getting the pre-

> certification that you got the surgery done. My oral surgeon's

> office won't even schedule the surgery until I have the pre-

> certification. So, I am really freaking out here. I only have

like

> 6 weeks until January is over, so I am *really* running out of

time!

>

> Is there anything I can do to speed up the certification process?

> (short of being an extreme nuisance to my oral surgeon)

>

> Thanks

>

[Guest guest]

Hi ,

I have Blue Cross and they approved my surgery within 3 days of

receiving all of the requisite information. That was on November

28. I called my OS right away because they knew I needed to have

surgery in December and I am now scheduled for lower jaw advancement

on Dec. 23. So - less than one month between approval and surgery.

However, the office staff for my OS had to rearrange some other

people's office visits so my surgeon could be available and they had

to make sure there was a a room at the hospital. So it seemed to

all work out for me, I was always upfront with the OS's staff about

the need to get it done soon after the insurance information went

through. But I too was worried up until the point when I made all

of the surgery appointments that time had already run out.

Good luck

Laurel

> Hi Guys,

>

> I am supposed to be getting a maxillary osteotomy to reduce the

> excess bone and gum tissue in my upper jaw in January. My

insurance

> company is dragging their heels and now wants molds, xrays, etc.

I

> absolutely have to get this done in January because my husbands

> employer won't pay for insurance after January (he's on Cobra). I

> was just wondering how long it was after getting the pre-

> certification that you got the surgery done. My oral surgeon's

> office won't even schedule the surgery until I have the pre-

> certification. So, I am really freaking out here. I only have

like

> 6 weeks until January is over, so I am *really* running out of

time!

>

> Is there anything I can do to speed up the certification process?

> (short of being an extreme nuisance to my oral surgeon)

>

> Thanks

>

[Guest guest]

Hi ,

I have Blue Cross and they approved my surgery within 3 days of

receiving all of the requisite information. That was on November

28. I called my OS right away because they knew I needed to have

surgery in December and I am now scheduled for lower jaw advancement

on Dec. 23. So - less than one month between approval and surgery.

However, the office staff for my OS had to rearrange some other

people's office visits so my surgeon could be available and they had

to make sure there was a a room at the hospital. So it seemed to

all work out for me, I was always upfront with the OS's staff about

the need to get it done soon after the insurance information went

through. But I too was worried up until the point when I made all

of the surgery appointments that time had already run out.

Good luck

Laurel

> Hi Guys,

>

> I am supposed to be getting a maxillary osteotomy to reduce the

> excess bone and gum tissue in my upper jaw in January. My

insurance

> company is dragging their heels and now wants molds, xrays, etc.

I

> absolutely have to get this done in January because my husbands

> employer won't pay for insurance after January (he's on Cobra). I

> was just wondering how long it was after getting the pre-

> certification that you got the surgery done. My oral surgeon's

> office won't even schedule the surgery until I have the pre-

> certification. So, I am really freaking out here. I only have

like

> 6 weeks until January is over, so I am *really* running out of

time!

>

> Is there anything I can do to speed up the certification process?

> (short of being an extreme nuisance to my oral surgeon)

>

> Thanks

>

[Guest guest]

Thanks everyone for your suggestions. My oral surgeon knows about my

insurance situation, so he has been making it clear on the paperwork

to the ins. co. that I have to have the surgery done in January. (of

course he didn't mention why I had to have it done in Jan.) His

office has assured me that as long as they get the approval by the

end of the month, I can be scheduled in January. I really appreciate

all your support, and hope that I will be joining all of you post-

oppers soon!

> > Hi Guys,

> >

> > I am supposed to be getting a maxillary osteotomy to reduce the

> > excess bone and gum tissue in my upper jaw in January. My

> insurance

> > company is dragging their heels and now wants molds, xrays, etc.

> I

> > absolutely have to get this done in January because my husbands

> > employer won't pay for insurance after January (he's on Cobra).

I

> > was just wondering how long it was after getting the pre-

> > certification that you got the surgery done. My oral surgeon's

> > office won't even schedule the surgery until I have the pre-

> > certification. So, I am really freaking out here. I only have

> like

> > 6 weeks until January is over, so I am *really* running out of

> time!

> >

> > Is there anything I can do to speed up the certification process?

> > (short of being an extreme nuisance to my oral surgeon)

> >

> > Thanks

> >