Guest guest Posted April 14, 2004 Report Share Posted April 14, 2004 P.S. to my previous message: For those who had the surgery, do you think it was all worth it at the end? > Hello everyone. > > I joined this group 2 days ago. I've had my braces for about 3 weeks now, > and will undergo surgery sometime next year (it will most likely be the > lower jaw only, but there is a slight possibility that they'll do the upper > one, too.) I have a lower jaw that's deviated to the right quite a bit, > and my upper one is deviated to the left (but very slightly). It is > actually not very noticeable, but this bad bite is causing TMJ malfunction, > locking jaw and quite a bit of gum recession. So, I decided that surgery > would be the way to go. I'm just starting to deal with my insurance > company, and it is very frustrating (they already denied my surgery as > medically unnecessary, and don't want to pay for my initial visit with the > OS, either). If anyone has stories about fights with insurance companies, > would you mind sharing them? I am planning to file an appeal with mine. > > Take care everybody, > Irene. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 14, 2004 Report Share Posted April 14, 2004 Hi Val, Thanks for the advice. I'll try to collect all the information. I wonder if I have the stamina to fight them though . I am prepared to pay out of pocket if necessary, and I am getting a pretty good deal from my surgeon (the surgery itself, if lower jaw only, comes out to just under $6,000 for everything (hospital stay, surgeon and anesthesia fees, etc.), which sounds like a great rate (it's just under $9,000 for upper and lower). I am in the Hartford, CT area. Irene. > Irene, > > There is no simple answer. Insurances do not like to pay if they > can avoid it, and this surgery has a known excuse - cosmetic effect > is always present, so you HAVE to prove it is not your only goal. > First of all - if it is excluded specifically - you have very little > chance. If not - collect ALL possible info on what king of > FUNCTIONAL impairments it causes you - eating, breathing, pain, etc. > Difficulty eating and myofacial pain are two good ones. You will > have to get a documented history - the more and longer, the more > MDs and DDSs/DMDs signatures - the better. Assemmble it and stard > bombarding them with it. Do it repeatedely and stay on the phone - > assume they will loose it and so on. Keep calling, complaining, > sending letters to state insurance departments and so on. > The more persistent you are, the better there is no limit! - wear > them down in return. Insurances count on people getting tired > and giving up - do not do it and they will give up. > Good luck! > > Val > > > P.S. Where are you from? > Quote Link to comment Share on other sites More sharing options...
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