Guest guest Posted October 13, 2004 Report Share Posted October 13, 2004 Wow! Your company is surely generous with the ortho payments. Generally, around here anyhow, a physician or surgeon (or dentist) or hospital that's " in-network " has agreed to accept what the insurance company deems a fair and comparable price for a given service. That's usually a lot less than the docs bill individuals. (it can make thousands of dollars' difference, or tens of thousands, when you're talking things like MRIs and Cat scans, not to mention surgery.) I think it's less a matter of them certifying his abilities than it is whether they have established this contractual relationship with him. Sometimes when there isn't an in-network doc anywhere near you, the company will let you use one who's not in their network and pay anyhow. But I don't know how much they'll pay. My surgeon, mercifully, was in-network. My ortho wasn't, but he was well worth the extra money, to me. Cammie > > I've already used up the maximum amount allowed for orthodontic work > through my insurance ($10,000!!). Although orthodontic work is > required for the surgery, my insurance refuses to cover it, so it'll > be about $6,000 out of my pocket... I've never heard of any > insurance company covering orthodontic work for this surgery. I'll > be gaining experience with HMOs, however. The surgeon I'm looking > to " hire " is not under my current insurance plan. I'm not too > knowledgable about this, but I think they'll have to approve him and > what not. I'd also love to hear any experiences people have had > with HMOs as well! > O. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 13, 2004 Report Share Posted October 13, 2004 Wow! Your company is surely generous with the ortho payments. Generally, around here anyhow, a physician or surgeon (or dentist) or hospital that's " in-network " has agreed to accept what the insurance company deems a fair and comparable price for a given service. That's usually a lot less than the docs bill individuals. (it can make thousands of dollars' difference, or tens of thousands, when you're talking things like MRIs and Cat scans, not to mention surgery.) I think it's less a matter of them certifying his abilities than it is whether they have established this contractual relationship with him. Sometimes when there isn't an in-network doc anywhere near you, the company will let you use one who's not in their network and pay anyhow. But I don't know how much they'll pay. My surgeon, mercifully, was in-network. My ortho wasn't, but he was well worth the extra money, to me. Cammie > > I've already used up the maximum amount allowed for orthodontic work > through my insurance ($10,000!!). Although orthodontic work is > required for the surgery, my insurance refuses to cover it, so it'll > be about $6,000 out of my pocket... I've never heard of any > insurance company covering orthodontic work for this surgery. I'll > be gaining experience with HMOs, however. The surgeon I'm looking > to " hire " is not under my current insurance plan. I'm not too > knowledgable about this, but I think they'll have to approve him and > what not. I'd also love to hear any experiences people have had > with HMOs as well! > O. > Quote Link to comment Share on other sites More sharing options...
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