Guest guest Posted January 28, 2005 Report Share Posted January 28, 2005 Tova - Everyone's situation is different of course. I was estimated a charge of 21K from my hospital here. Your hospital/surgery was definitely cheaper in your case. But I think other people have posted that their hospitals were expensive. Come to think of it, I think the hospital charges are contingent on what you're having done. In my case, I'm having upper and lower jaw surgery. That probably makes my surgery longer and more complex. So back to - depending on what procedure(s) you're having done, will affect both the hospital and the surgeon - in your case, I know you are interested in the surgeon's fees. Well, the 14K that I mentioned before, is based on upper and lower. If it were single jaw surgery - my cost would have been around $6,500 for the surgeon and $10,000 for the hospital. Tova - this is closer to your cost and it makes sense, you had single jaw surgery. T Tova Friedman wrote: That's weird... as far as I was made aware, the $16,000 covered the doctor and hospital... everything--- god help me if I get a $55,000 bill for the Hospital stay! -Tova > > I went through something very similar. The surgeon's fees (from what > I've seen) are usually in the range of 10-15K. Some may be higher, > actually I remember a quote for 25K for just the surgeon and I was > like, see ya! The surgeon that I decided to go with, is charging 14K > - everything inclusive - x-rays, photographs, impressions, > pre-surgical visit (physical), assistant surgeon, and of course, him. > > what state do you live in? If you are anywhere near North Carolina - > I would Suggest the University Oral and Maxillofacial Surgery. There > are a total of 7 oral surgeons there and they all rock! The best part > is, you are getting great surgeons at a reasonable cost since they are > based in North Carolina - a cheaper state relative to the rest of the > county. > > On the bright side - your hospital stay is covered!! Do you know how > HUGE that is?? I've heard of hospital bills be up to 55K - so that is > at least one thing to celebrate!! > > T > > Weidel wrote: > > My surgeon's office had contacted my insurance company to get > preauthorization for my lower jaw advancement in 2003, got approval > for inpatient surgery and 2 days in the hospital in July 2003. So I > went ahead and got braces to get ready for the surgery. > > My company's group number changed, so we needed to resubmit the claim, > which was just denied. When I talked to my insurance company (Cigna) > yesterday, they explained that the original form that my surgeon > submitted was only for the hospital, not for the surgery. The only > oral surgery coverage I have is to have wisdom teeth removed. > > So - is there another way to submit the claim? Does this kind of > surgery fall under some other sort of classification, other than oral > surgery? B/c what if something else was wrong with something in my > mouth, like cancer? There must be something, since people need oral > surgery for things other than just wisdom teeth!! > > Has anyone else had experience with this? Is your surgery covered > under something other than your oral surgery benefits? Any idea of how > much the surgeon fees would be? It looks like they'll pay for the OR, > meds, and hospital stay still. > > Thanks! > > Steph > > > > > > --------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2005 Report Share Posted January 28, 2005 Tania, That does make sense... thanks for filling in the blanks.. I was starting to panic! I also saw in the pics that some people were there for many days...I was let out by noon the next day. Obviously, that makes a difference too. Tova > > Tova - Everyone's situation is different of course. I was estimated a > charge of 21K from my hospital here. Your hospital/surgery was > definitely cheaper in your case. But I think other people have posted > that their hospitals were expensive. > > Come to think of it, I think the hospital charges are contingent on > what you're having done. In my case, I'm having upper and lower jaw > surgery. That probably makes my surgery longer and more complex. So > back to - depending on what procedure(s) you're having done, > will affect both the hospital and the surgeon - in your case, I know > you are interested in the surgeon's fees. Well, the 14K that I > mentioned before, is based on upper and lower. If it were single jaw > surgery - my cost would have been around $6,500 for the surgeon and > $10,000 for the hospital. Tova - this is closer to your cost and it > makes sense, you had single jaw surgery. > > T > Tova Friedman wrote: > > That's weird... as far as I was made aware, the $16,000 covered the > doctor and hospital... everything--- god help me if I get a $55,000 > bill for the Hospital stay! > > -Tova > > >> >> I went through something very similar. The surgeon's fees (from what >> I've seen) are usually in the range of 10-15K. Some may be higher, >> actually I remember a quote for 25K for just the surgeon and I was >> like, see ya! The surgeon that I decided to go with, is charging 14K >> - everything inclusive - x-rays, photographs, impressions, >> pre-surgical visit (physical), assistant surgeon, and of course, him. >> >> what state do you live in? If you are anywhere near North Carolina - >> I would Suggest the University Oral and Maxillofacial Surgery. There >> are a total of 7 oral surgeons there and they all rock! The best part >> is, you are getting great surgeons at a reasonable cost since they are >> based in North Carolina - a cheaper state relative to the rest of the >> county. >> >> On the bright side - your hospital stay is covered!! Do you know how >> HUGE that is?? I've heard of hospital bills be up to 55K - so that is >> at least one thing to celebrate!! >> >> T >> >> Weidel wrote: >> >> My surgeon's office had contacted my insurance company to get >> preauthorization for my lower jaw advancement in 2003, got approval >> for inpatient surgery and 2 days in the hospital in July 2003. So I >> went ahead and got braces to get ready for the surgery. >> >> My company's group number changed, so we needed to resubmit the claim, >> which was just denied. When I talked to my insurance company (Cigna) >> yesterday, they explained that the original form that my surgeon >> submitted was only for the hospital, not for the surgery. The only >> oral surgery coverage I have is to have wisdom teeth removed. >> >> So - is there another way to submit the claim? Does this kind of >> surgery fall under some other sort of classification, other than oral >> surgery? B/c what if something else was wrong with something in my >> mouth, like cancer? There must be something, since people need oral >> surgery for things other than just wisdom teeth!! >> >> Has anyone else had experience with this? Is your surgery covered >> under something other than your oral surgery benefits? Any idea of how >> much the surgeon fees would be? It looks like they'll pay for the OR, >> meds, and hospital stay still. >> >> Thanks! >> >> Steph >> >> >> >> >> >> --------------------------------- >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2005 Report Share Posted January 28, 2005 Hi -- thanks for the help! I'm most likely just having lower done, possibly upper too. My ortho said they'd make a final decision based on how things are looking closer to surgery. My surgeon is Lawrence Levin at University of Pennsylvania Medical Center. Could I ask for an estimate of how much his fees would be? Maybe higher than NC rates? I'm switching jobs in a couple of weeks and was trying to decide between paying COBRA to keep my current benefits with Cigna ($368/month!) or to try my luck with my new job's insurance. But if hospital fees run that high and it looks like at least that much is covered with Cigna, it could be best to pay the COBRA -- at least I know they'll probably pay most of it. > > > > My surgeon's office had contacted my insurance company to get > > preauthorization for my lower jaw advancement in 2003, got approval > > for inpatient surgery and 2 days in the hospital in July 2003. So I > > went ahead and got braces to get ready for the surgery. > > > > My company's group number changed, so we needed to resubmit the claim, > > which was just denied. When I talked to my insurance company (Cigna) > > yesterday, they explained that the original form that my surgeon > > submitted was only for the hospital, not for the surgery. The only > > oral surgery coverage I have is to have wisdom teeth removed. > > > > So - is there another way to submit the claim? Does this kind of > > surgery fall under some other sort of classification, other than oral > > surgery? B/c what if something else was wrong with something in my > > mouth, like cancer? There must be something, since people need oral > > surgery for things other than just wisdom teeth!! > > > > Has anyone else had experience with this? Is your surgery covered > > under something other than your oral surgery benefits? Any idea of how > > much the surgeon fees would be? It looks like they'll pay for the OR, > > meds, and hospital stay still. > > > > Thanks! > > > > Steph > > > > > > > > > > > > --------------------------------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2005 Report Share Posted January 28, 2005 My doctor was very familiar with which insurance carriers were more likely to cover it and which would give a hard time... you should probably ask him before deciding which insurance is better for you. > > Hi -- thanks for the help! I'm most likely just having lower done, > possibly upper too. My ortho said they'd make a final decision based > on how things are looking closer to surgery. > > My surgeon is Lawrence Levin at University of Pennsylvania Medical > Center. Could I ask for an estimate of how much his fees would be? > Maybe higher than NC rates? > > I'm switching jobs in a couple of weeks and was trying to decide > between paying COBRA to keep my current benefits with Cigna > ($368/month!) or to try my luck with my new job's insurance. But if > hospital fees run that high and it looks like at least that much is > covered with Cigna, it could be best to pay the COBRA -- at least I > know they'll probably pay most of it. > > > > > > > > > My surgeon's office had contacted my insurance company to get > > > preauthorization for my lower jaw advancement in 2003, got > approval > > > for inpatient surgery and 2 days in the hospital in July 2003. So > I > > > went ahead and got braces to get ready for the surgery. > > > > > > My company's group number changed, so we needed to resubmit the > claim, > > > which was just denied. When I talked to my insurance company > (Cigna) > > > yesterday, they explained that the original form that my surgeon > > > submitted was only for the hospital, not for the surgery. The only > > > oral surgery coverage I have is to have wisdom teeth removed. > > > > > > So - is there another way to submit the claim? Does this kind of > > > surgery fall under some other sort of classification, other than > oral > > > surgery? B/c what if something else was wrong with something in my > > > mouth, like cancer? There must be something, since people need > oral > > > surgery for things other than just wisdom teeth!! > > > > > > Has anyone else had experience with this? Is your surgery covered > > > under something other than your oral surgery benefits? Any idea > of how > > > much the surgeon fees would be? It looks like they'll pay for the > OR, > > > meds, and hospital stay still. > > > > > > Thanks! > > > > > > Steph > > > > > > > > > > > > > > > > > > --------------------------------- > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2005 Report Share Posted January 28, 2005 Are you filing under your medical (not dental) coverage? Worth a try, filing for repair of a congenital skeletal defect or abnormality. My surgeon even specified that this was not tmj surgery, not cosmetic surgery... Of course, I didn't have Cigna, either. Your surgeon, as I've said before, is your best ally. Probably he needs to document grinding, headaches or whatever else you have going on. (No, I'm not suggesting in any way that you ask him to collude with you to lie to your insurance company. That's illegal. But many times the truth -- plus letting them know that you're prepared to fight if they wanna do it that way, will change their minds.) Send copies of models, photos, drawings, any other supporting documents you have. (And keep careful records of what you send -- best to insure or send certified, with return receipts requested. I don't remember Cigna as being particularly bad guys, but some companies have " lost " repeated submissions, or denied receiving them, as, I believe, a stalling tactic.) Also keep detailed records and files of any conversations you have with them, or letters, including the dates and the names of those with whom you spoke, plus a record of the conversation, and the positions of the people in the insurance company. In short, proceed carefully and document everything. My own insurance company was most excellent. Some are. Others can be real stinkers. My policy also provides that I can request a review by a panel of maxillofacial and oral surgeons, which i did in another instance not related to this surgery. Good luck to you. Cammie > > My surgeon's office had contacted my insurance company to get > preauthorization for my lower jaw advancement in 2003, got approval > for inpatient surgery and 2 days in the hospital in July 2003. So I > went ahead and got braces to get ready for the surgery. > > My company's group number changed, so we needed to resubmit the claim, > which was just denied. When I talked to my insurance company (Cigna) > yesterday, they explained that the original form that my surgeon > submitted was only for the hospital, not for the surgery. The only > oral surgery coverage I have is to have wisdom teeth removed. > > So - is there another way to submit the claim? Does this kind of > surgery fall under some other sort of classification, other than oral > surgery? B/c what if something else was wrong with something in my > mouth, like cancer? There must be something, since people need oral > surgery for things other than just wisdom teeth!! > > Has anyone else had experience with this? Is your surgery covered > under something other than your oral surgery benefits? Any idea of how > much the surgeon fees would be? It looks like they'll pay for the OR, > meds, and hospital stay still. > > Thanks! > > Steph Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2005 Report Share Posted January 28, 2005 If you know what the insurance company will be, why not ask for a copy of the policy so you can see what it says. Do beware the " pre-existing condition " trap, or you may wind up having to wait. And I'm not sure how that works. Lord, sometimes it seems that this stuff is totally rigged in favor of the insurance companies and against the poor patient. (Well, at least he or she is poor afterward, if the insurance company doesn't come through.) And my company, as I've said before, was excellent, in no small part because my employer provides an excellent policy, thank heavens! cammie > > Hi -- thanks for the help! I'm most likely just having lower done, > possibly upper too. My ortho said they'd make a final decision based > on how things are looking closer to surgery. > > My surgeon is Lawrence Levin at University of Pennsylvania Medical > Center. Could I ask for an estimate of how much his fees would be? > Maybe higher than NC rates? > > I'm switching jobs in a couple of weeks and was trying to decide > between paying COBRA to keep my current benefits with Cigna > ($368/month!) or to try my luck with my new job's insurance. But if > hospital fees run that high and it looks like at least that much is > covered with Cigna, it could be best to pay the COBRA -- at least I > know they'll probably pay most of it. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2005 Report Share Posted April 28, 2005 Hi Guys This is Chaundra, I haven't posted in a really long time, b/c I have been super busy in school. I just wanted to know if anyone on this site had United Healthcare (Choice Plan). I am having some problems with my insurance company and I have had to reschedule my procedure once already. Any advice from anyone would really be helpful. Thanks So Much Chaundra Quote Link to comment Share on other sites More sharing options...
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