Switching surgeons for insurance

[Guest guest]

Hi, my fiancee needs orthognathic surgery. SHe's been in braces for

almost a year while we're dealing with insurance issues. We have been

working with an out-of-network surgeon (first mistake) for a while

now, and we recently had the procedure preapproved by the insurance

company. However, for a $16k surgery (not including hospital

fees--that's only the surgeon fees for both jaws), the insurance is

happy to pay a whopping $2.5k. They said they're using the " Medicare

fee guidelines " to get those numbers, and that " they have no control

over those numbers " . The surgeon isn't interested in negotiation or

meeting in the middle, or anything, so we're trying to switch to an

in-network surgeon in the University of North Carolina, Chapel Hill

hospital, hopefully for better coverage and insurance support from the

surgeon's office.

Does anyone have any experiences like this? How did it go?

Thanks!

[Guest guest]

I posted this earlier, but in case you did not see it. There is a

surgeon there that did a friend's daughter's surgery. They really like

him. His name is Dr. Turvey or something similar. He is at UNC and he

does good work. She is also in a study, so she documents her recovery

and they pay her for that (I think $75. a booklet). I would go, but

they do not take my insurance. I am in NC, but I have a surgeon in

Goldsboro. I will get the number if you like. Let me know.

Rene`

> Hi, my fiancee needs orthognathic surgery. SHe's been in braces for

> almost a year while we're dealing with insurance issues. We have been

> working with an out-of-network surgeon (first mistake) for a while

> now, and we recently had the procedure preapproved by the insurance

> company. However, for a $16k surgery (not including hospital

> fees--that's only the surgeon fees for both jaws), the insurance is

> happy to pay a whopping $2.5k. They said they're using the " Medicare

> fee guidelines " to get those numbers, and that " they have no control

> over those numbers " . The surgeon isn't interested in negotiation or

> meeting in the middle, or anything, so we're trying to switch to an

> in-network surgeon in the University of North Carolina, Chapel Hill

> hospital, hopefully for better coverage and insurance support from the

> surgeon's office.

>

> Does anyone have any experiences like this? How did it go?

>

> Thanks!