advice regarding health coverage

[Guest guest]

I was wondering if any one in this group could give me some advice.

My situation is this. I need upper and lower jaw surgery to repair

my bite but I am having insurance problems. I have had braces now

for about 4 months and things seemed to be going fine until my visit

with my surgeon. They want up front consultations fees and they dont

even guarantee that my insurance will cover me. My orthodondist

tells me that I need to go to these visits and pay the surgeon so he

can better understand my situation to better represent me to my

insurance copany.

[Guest guest]

Your situation isn't unusual. That's what I did, too, although I only

needed lower.

I think the initial consult was about $115. (My ortho had already

done molds, x-rays, drawings, etc, and my surgeon was willing to use

those, as the two have worked together for a long, long time.)

I can't remember whether my insurance paid that, or whether I

eventually absorbed that cost. It was well worth the money, as my

surgeon spent hours with me, answering all my questions and telling

me in detail what the risks and benefits might be.

My surgeon did indeed file the request for precertification, and got

it on the first attempt. When that lapsed before I was ready for

surgery, he also filed a request for renewal, and got it. You really,

really do want your surgeon to be your advocate with your insurance

company.

Cammie

> I was wondering if any one in this group could give me some

advice.

> My situation is this. I need upper and lower jaw surgery to repair

> my bite but I am having insurance problems. I have had braces now

> for about 4 months and things seemed to be going fine until my

visit

> with my surgeon. They want up front consultations fees and they

dont

> even guarantee that my insurance will cover me. My orthodondist

> tells me that I need to go to these visits and pay the surgeon so

he

> can better understand my situation to better represent me to my

> insurance copany.

[Guest guest]

Your situation isn't unusual. That's what I did, too, although I only

needed lower.

I think the initial consult was about $115. (My ortho had already

done molds, x-rays, drawings, etc, and my surgeon was willing to use

those, as the two have worked together for a long, long time.)

I can't remember whether my insurance paid that, or whether I

eventually absorbed that cost. It was well worth the money, as my

surgeon spent hours with me, answering all my questions and telling

me in detail what the risks and benefits might be.

My surgeon did indeed file the request for precertification, and got

it on the first attempt. When that lapsed before I was ready for

surgery, he also filed a request for renewal, and got it. You really,

really do want your surgeon to be your advocate with your insurance

company.

Cammie

> I was wondering if any one in this group could give me some

advice.

> My situation is this. I need upper and lower jaw surgery to repair

> my bite but I am having insurance problems. I have had braces now

> for about 4 months and things seemed to be going fine until my

visit

> with my surgeon. They want up front consultations fees and they

dont

> even guarantee that my insurance will cover me. My orthodondist

> tells me that I need to go to these visits and pay the surgeon so

he

> can better understand my situation to better represent me to my

> insurance copany.

[Guest guest]

Your situation isn't unusual. That's what I did, too, although I only

needed lower.

I think the initial consult was about $115. (My ortho had already

done molds, x-rays, drawings, etc, and my surgeon was willing to use

those, as the two have worked together for a long, long time.)

I can't remember whether my insurance paid that, or whether I

eventually absorbed that cost. It was well worth the money, as my

surgeon spent hours with me, answering all my questions and telling

me in detail what the risks and benefits might be.

My surgeon did indeed file the request for precertification, and got

it on the first attempt. When that lapsed before I was ready for

surgery, he also filed a request for renewal, and got it. You really,

really do want your surgeon to be your advocate with your insurance

company.

Cammie

> I was wondering if any one in this group could give me some

advice.

> My situation is this. I need upper and lower jaw surgery to repair

> my bite but I am having insurance problems. I have had braces now

> for about 4 months and things seemed to be going fine until my

visit

> with my surgeon. They want up front consultations fees and they

dont

> even guarantee that my insurance will cover me. My orthodondist

> tells me that I need to go to these visits and pay the surgeon so

he

> can better understand my situation to better represent me to my

> insurance copany.