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]

I'm not an expert, but here's what I think: If your surgeon's

office has submitted pre-certification paperwork for the surgery and

it has been approved, don't worry too much about whether or not your

insurance will cover the surgery at this point. My experience was

that my insurance pre-certified the surgery but would not commit to

absolute coverage until basically when they paid their portion of

the surgery bill, which was after the procedure had been peformed.

If your surgeon's office has not submitted pre-certification

paperwork, ask them to do so. Even with the pre-certification early

in my treatment, my surgeon's office still re-submitted shortly

before I had my procedure to have it approved again.

Best to you,

> 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]

I'm not an expert, but here's what I think: If your surgeon's

office has submitted pre-certification paperwork for the surgery and

it has been approved, don't worry too much about whether or not your

insurance will cover the surgery at this point. My experience was

that my insurance pre-certified the surgery but would not commit to

absolute coverage until basically when they paid their portion of

the surgery bill, which was after the procedure had been peformed.

If your surgeon's office has not submitted pre-certification

paperwork, ask them to do so. Even with the pre-certification early

in my treatment, my surgeon's office still re-submitted shortly

before I had my procedure to have it approved again.

Best to you,

> 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]

I'm not an expert, but here's what I think: If your surgeon's

office has submitted pre-certification paperwork for the surgery and

it has been approved, don't worry too much about whether or not your

insurance will cover the surgery at this point. My experience was

that my insurance pre-certified the surgery but would not commit to

absolute coverage until basically when they paid their portion of

the surgery bill, which was after the procedure had been peformed.

If your surgeon's office has not submitted pre-certification

paperwork, ask them to do so. Even with the pre-certification early

in my treatment, my surgeon's office still re-submitted shortly

before I had my procedure to have it approved again.

Best to you,

> 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.