Pre-Auth Letter

[Guest guest]

After fighting long and hard with United Health Care to get myself

covered, I finally received a copy of the pre-auth letter for

orthognathic surgery.

So, anyway, I was in my Ortho's office a few days ago, and I told him

that I'm set to go with surgery, and to please hurry up and close the

few remaining gaps in my lower teeth, and he said that he's heard of

times that even though the patient had the pre-auth letter, there

were still holdups.

My question out there is has anyone else had this happen? Is this

really not the end of the battle with my insurance carrier? I mean,

they can't change their minds, can they? I should be having my

surgery by June (or early July depending on my lower teeth closing so

slowly), so I'll at least have the same insurance carrier for this

whole year (I've heard of times when ins. carriers change, people

have to get pre-authorized again..)

Thanks!

-Blake

[Guest guest]

i'm on UHC too and they approved part of the surgery but not all of

it. they gave us a verbal approval over the phone and i tried to get

them to give me written, but we ( " we " meaning the insurance lady as

the surgeon's office and me) talked to the same guy a few times and

he assured us that most of it was approved. i ended up having to pay

for some of the surgery out of pocket, but the human resources

department is trying to talk UHC into reimbursing me for that too. i

hope they don't go back on the whole thing b/c there is no way i'll

be able to afford it if they don't pay. but i've had some good

people to help me. my HR department and the people at my OS office

have done so much to help me.

all that to say... insurance is a pain. but i would imagine if you

have a pre-authorization in writing, that really doesn't give them

much of a chance to back out at this point.

>

>

> After fighting long and hard with United Health Care to get myself

> covered, I finally received a copy of the pre-auth letter for

> orthognathic surgery.

>

> So, anyway, I was in my Ortho's office a few days ago, and I told

him

> that I'm set to go with surgery, and to please hurry up and close

the

> few remaining gaps in my lower teeth, and he said that he's heard

of

> times that even though the patient had the pre-auth letter, there

> were still holdups.

>

> My question out there is has anyone else had this happen? Is this

> really not the end of the battle with my insurance carrier? I

mean,

> they can't change their minds, can they? I should be having my

> surgery by June (or early July depending on my lower teeth closing

so

> slowly), so I'll at least have the same insurance carrier for this

> whole year (I've heard of times when ins. carriers change, people

> have to get pre-authorized again..)

>

> Thanks!

>

> -Blake

[Guest guest]

Well, I have heard of insurance companies doing all sorts of wormy,

squirmy things to try to discourage their clientele from filing

claims.

I would say, put that letter in a very safe place. Make a copy, and

put the copy in a very safe place, too. And be prepared to hold their

feet to the fire. The more documentation YOU have, the weaker their

case, if it comes to that, will be. And yes, I have heard of folks

having to take insurance companies to court, although I don't

remember anybody having had to do that for a preauthorized procedure.

Congratulations, and good wishes to you!

Cammie

>

>

> After fighting long and hard with United Health Care to get myself

> covered, I finally received a copy of the pre-auth letter for

> orthognathic surgery.

>

> So, anyway, I was in my Ortho's office a few days ago, and I told

him

> that I'm set to go with surgery, and to please hurry up and close

the

> few remaining gaps in my lower teeth, and he said that he's heard

of

> times that even though the patient had the pre-auth letter, there

> were still holdups.

>

> My question out there is has anyone else had this happen? Is this

> really not the end of the battle with my insurance carrier? I

mean,

> they can't change their minds, can they? I should be having my

> surgery by June (or early July depending on my lower teeth closing

so

> slowly), so I'll at least have the same insurance carrier for this

> whole year (I've heard of times when ins. carriers change, people

> have to get pre-authorized again..)

>

> Thanks!

>

> -Blake

[Guest guest]

I have not had my surgery yet (won't be until next year) but the

insurance lady at my OS's office said that some insurance companies

have called them the day before a surgery to say that they changed

their mind and they would only cover part of it or sometimes not

cover any of it...THE DAY BEFORE!

I received my pre-authorization letter, and in it, it says that they

will cover 100% as long as it is " medically necessary. "

Good luck...

>

>

> After fighting long and hard with United Health Care to get myself

> covered, I finally received a copy of the pre-auth letter for

> orthognathic surgery.

>

> So, anyway, I was in my Ortho's office a few days ago, and I told

him

> that I'm set to go with surgery, and to please hurry up and close

the

> few remaining gaps in my lower teeth, and he said that he's heard

of

> times that even though the patient had the pre-auth letter, there

> were still holdups.

>

> My question out there is has anyone else had this happen? Is this

> really not the end of the battle with my insurance carrier? I

mean,

> they can't change their minds, can they? I should be having my

> surgery by June (or early July depending on my lower teeth closing

so

> slowly), so I'll at least have the same insurance carrier for this

> whole year (I've heard of times when ins. carriers change, people

> have to get pre-authorized again..)

>

> Thanks!

>

> -Blake