Re: How MUCH does this cost?

[Guest guest]

If so, the Canadian government is incredibly generous!

I remember you -- how are you doing? Are things better for you, now

that the surgery is over?

Cammie

> > >

> > > I recently saw an oral surgeon, Dr. Riley (in Palo

Alto),

> > and am considering having

> > > upper jaw surgery to correct my openbite/crossbite/class III.

> > >

> > > I finally decided to go ahead with orthodontics, but I have to

> > say, Dr. Riley's office has not

> > > been terribly helpful here. I called them and they wouldn't

> > really give me any information

> > > and told me to call my insurance company; they are not in any

> > insurance network.

> > >

> > > I have coverage through a large company with BlueCross (in

their

> > PPO plan). I asked Dr.

> > > Riley's office if they could give me an estimate but they said

> > they don't deal with insurance

> > > companies, plans, etc...although I'm SURE they must have had

> > another patient who had

> > > BlueCross PPO.

> > >

> > > All I want to know is what I will be required to pay, out of

> > pocket, for this surgery. I have

> > > called BlueCross and they are almost entirely clueless---plus

all

> > I can tell them is that I

> > > would be having orthognathic surgery of my upper jaw. They

told

> > me to call the doctor,

> > > but the doctor tells me to call the insurance company. When I

> > asked about the hospital

> > > fee, the person I spoke with at Dr. Riley's office told me to

call

> > the hospital. I mean this is

> > > really ridiculous that there is apparently 0 coordination here.

> > >

> > > Dr. Riley (when I met with him) indicated that the gross fees

for

> > this surgery, including his

> > > fee + hospital fee, would most likely be upwards of $50,000 as

the

> > hospital fee is $30,000

> > > per day. (ridiculous, in my opinion). If I have this surgery

and

> > am stuck with a $50,000

> > > bill, I will not be thrilled nor financially capable of paying

it.

> > >

> > > Is there some way to streamline this process to find out (a) if

> > the insurance company will

> > > cover anything, ( what they will cover, © what an

approximate

> > out of pocket cost is?

> > >

> > > It would be really helpful if anyone from this area (Bay Area,

> > California) has gone through

> > > this with BlueCross PPO.

> > >

> > > Thanks so much,

> > >

> > >

[Guest guest]

Hi,

I'm in NY, having my sx (upper/lower) in NY, and I'm expecting to pay

maybe $200-$300 including OS copays before and after surgery with my

insurance. After the cost of the braces, I don't think I could have

afforded to then pay $4,000 for the surgery. I think in the US, it

depends on an individual's insurance plan/coverage and location. So,

in my case, I couldn't afford to have the Sx done in Canada. As my

doctor put it to me, he doesn't make an money on these surgeries...

Katja

> > >

> > > I recently saw an oral surgeon, Dr. Riley (in Palo

Alto),

> > and am considering having

> > > upper jaw surgery to correct my openbite/crossbite/class III.

> > >

> > > I finally decided to go ahead with orthodontics, but I have to

> > say, Dr. Riley's office has not

> > > been terribly helpful here. I called them and they wouldn't

> > really give me any information

> > > and told me to call my insurance company; they are not in any

> > insurance network.

> > >

> > > I have coverage through a large company with BlueCross (in

their

> > PPO plan). I asked Dr.

> > > Riley's office if they could give me an estimate but they said

> > they don't deal with insurance

> > > companies, plans, etc...although I'm SURE they must have had

> > another patient who had

> > > BlueCross PPO.

> > >

> > > All I want to know is what I will be required to pay, out of

> > pocket, for this surgery. I have

> > > called BlueCross and they are almost entirely clueless---plus

all

> > I can tell them is that I

> > > would be having orthognathic surgery of my upper jaw. They

told

> > me to call the doctor,

> > > but the doctor tells me to call the insurance company. When I

> > asked about the hospital

> > > fee, the person I spoke with at Dr. Riley's office told me to

call

> > the hospital. I mean this is

> > > really ridiculous that there is apparently 0 coordination here.

> > >

> > > Dr. Riley (when I met with him) indicated that the gross fees

for

> > this surgery, including his

> > > fee + hospital fee, would most likely be upwards of $50,000 as

the

> > hospital fee is $30,000

> > > per day. (ridiculous, in my opinion). If I have this surgery

and

> > am stuck with a $50,000

> > > bill, I will not be thrilled nor financially capable of paying

it.

> > >

> > > Is there some way to streamline this process to find out (a) if

> > the insurance company will

> > > cover anything, ( what they will cover, © what an

approximate

> > out of pocket cost is?

> > >

> > > It would be really helpful if anyone from this area (Bay Area,

> > California) has gone through

> > > this with BlueCross PPO.

> > >

> > > Thanks so much,

> > >

> > >

[Guest guest]

I'm in NY too... had only lower jaw...I paid $6,000 for the braces,

$200 to the surgeon for a consult, $500 deductable towards the

surgery, and my insurance paid $16,500 to my doctor and the hospital.

Don't know how much of that went where.

Seems odd for a surgeon to A-not make any money on the surgery and

B-tell a patient he makes nothing on these surgeries whether or not

it's true. Sorta none of the patient's business and besides... Is he

doing it for his health? Sorta like the guy who fixes your leaking

roof trying to convince you he's got the best prices cuz he doesn't

charge for labor- only materials... I don't know... not to sound like a

cynical NYer but it sounds weird.

>

> Hi,

> I'm in NY, having my sx (upper/lower) in NY, and I'm expecting to pay

> maybe $200-$300 including OS copays before and after surgery with my

> insurance. After the cost of the braces, I don't think I could have

> afforded to then pay $4,000 for the surgery. I think in the US, it

> depends on an individual's insurance plan/coverage and location. So,

> in my case, I couldn't afford to have the Sx done in Canada. As my

> doctor put it to me, he doesn't make an money on these surgeries...

> Katja

>

>

> > > >

> > > > I recently saw an oral surgeon, Dr. Riley (in Palo

> Alto),

> > > and am considering having

> > > > upper jaw surgery to correct my openbite/crossbite/class III.

> > > >

> > > > I finally decided to go ahead with orthodontics, but I have to

> > > say, Dr. Riley's office has not

> > > > been terribly helpful here.  I called them and they wouldn't

> > > really give me any information

> > > > and told me to call my insurance company; they are not in any

> > > insurance network.

> > > >

> > > > I have coverage through a large company with BlueCross (in

> their

> > > PPO plan).  I asked Dr.

> > > > Riley's office if they could give me an estimate but they said

> > > they don't deal with insurance

> > > > companies, plans, etc...although I'm SURE they must have had

> > > another patient who had

> > > > BlueCross PPO.

> > > >

> > > > All I want to know is what I will be required to pay, out of

> > > pocket, for this surgery.  I have

> > > > called BlueCross and they are almost entirely clueless---plus

> all

> > > I can tell them is that I

> > > > would be having orthognathic surgery of my upper jaw.  They

> told

> > > me to call the doctor,

> > > > but the doctor tells me to call the insurance company.  When I

> > > asked about the hospital

> > > > fee, the person I spoke with at Dr. Riley's office told me to

> call

> > > the hospital.  I mean this is

> > > > really ridiculous that there is apparently 0 coordination here.

> > > >

> > > > Dr. Riley (when I met with him) indicated that the gross fees

> for

> > > this surgery, including his

> > > > fee + hospital fee, would most likely be upwards of $50,000 as

> the

> > > hospital fee is $30,000

> > > > per day.  (ridiculous, in my opinion).  If I have this surgery

> and

> > > am stuck with a $50,000

> > > > bill, I will not be thrilled nor financially capable of paying

> it.

> > > >

> > > > Is there some way to streamline this process to find out (a) if

> > > the insurance company will

> > > > cover anything, ( what they will cover, © what an

> approximate

> > > out of pocket cost is?

> > > >

> > > > It would be really helpful if anyone from this area (Bay Area,

> > > California) has gone through

> > > > this with BlueCross PPO.

> > > >

> > > > Thanks so much,

> > > >

> > > >

>

>

>

>

>

>

>

[Guest guest]

Well, The surgeon lives in NY too... maybe he's ALSO a cynical

NYer???

Probably, he was making commentary on the insurance system. If the

insurance operates a certain way, why does it matter if the doctor

says anything about it or not. Discussing it doesn't change

anything. If you've been involved with insurance- claims, etc. and

are a basic policy holder, it's not really complicated to figure out

how they operate. Let me spell it out, A if the insurance company

sets the prices. B They only pay the prices they have themselves set-

Then C It's possibe that a surgeon isn't going to percieve the

surgery as a big money maker since he is at the mercy of the

insurance company. " Sorta " like if the guy who fixes the roof has

somebody telling him he CANT charge for labor and isn't going to get

paid for labor. So, it's actually pretty simple, and not

really " wierd " .

As has already been discussed on this panel ad infinitum, the

insurance companies are not out to be anybody's friend or to make

anybody else but themselves money. Really, I don't understand how it

is or isn't a patient's business. It's " sorta " the surgeon's

prerrogative to disclose what he wishes. I would be more skeptical

if my doctor wasn't straightforward and honest with me. It might

just be my surgeon's demeanor- not trying to hide or sugar coat

anything to his patients. Personally, I don't need him to present

some pretty wrapped package, the truth doesn't change whether I know

it or not, ya know?

Since the surgeon and I didn't discuss his income at length, I have

no idea if his possibly teaching at the UR med school somehow

fincancially compensates. We didn't really delve. And I guess, it's

the wisdom teeth and such that are the bigger " money makers " .

Probably when he commented on " making money " he was referring to a

Profit. Figurative speech can be hard to understand, particularly

when taken out of context or if the commentator wasn't present for

the conversation. Don't you think?

But maybe it's all just so big and different downstate that in is

upstate.

Katja

> > > > >

> > > > > I recently saw an oral surgeon, Dr. Riley (in Palo

> > Alto),

> > > > and am considering having

> > > > > upper jaw surgery to correct my openbite/crossbite/class

III.

> > > > >

> > > > > I finally decided to go ahead with orthodontics, but I

have to

> > > > say, Dr. Riley's office has not

> > > > > been terribly helpful here.  I called them and they

wouldn't

> > > > really give me any information

> > > > > and told me to call my insurance company; they are not in

any

> > > > insurance network.

> > > > >

> > > > > I have coverage through a large company with BlueCross (in

> > their

> > > > PPO plan).  I asked Dr.

> > > > > Riley's office if they could give me an estimate but they

said

> > > > they don't deal with insurance

> > > > > companies, plans, etc...although I'm SURE they must have

had

> > > > another patient who had

> > > > > BlueCross PPO.

> > > > >

> > > > > All I want to know is what I will be required to pay, out

of

> > > > pocket, for this surgery.  I have

> > > > > called BlueCross and they are almost entirely clueless---

plus

> > all

> > > > I can tell them is that I

> > > > > would be having orthognathic surgery of my upper jaw. 

They

> > told

> > > > me to call the doctor,

> > > > > but the doctor tells me to call the insurance company. 

When I

> > > > asked about the hospital

> > > > > fee, the person I spoke with at Dr. Riley's office told

me to

> > call

> > > > the hospital.  I mean this is

> > > > > really ridiculous that there is apparently 0 coordination

here.

> > > > >

> > > > > Dr. Riley (when I met with him) indicated that the gross

fees

> > for

> > > > this surgery, including his

> > > > > fee + hospital fee, would most likely be upwards of

$50,000 as

> > the

> > > > hospital fee is $30,000

> > > > > per day.  (ridiculous, in my opinion).  If I have this

surgery

> > and

> > > > am stuck with a $50,000

> > > > > bill, I will not be thrilled nor financially capable of

paying

> > it.

> > > > >

> > > > > Is there some way to streamline this process to find out

(a) if

> > > > the insurance company will

> > > > > cover anything, ( what they will cover, © what an

> > approximate

> > > > out of pocket cost is?

> > > > >

> > > > > It would be really helpful if anyone from this area (Bay

Area,

> > > > California) has gone through

> > > > > this with BlueCross PPO.

> > > > >

> > > > > Thanks so much,

> > > > >

> > > > >

> >

> >

> >

> >

> >

> >

> >