Re: Insurance question: BCBS of Mass.

[Guest guest]

Hi

I have a PPO plan from BCBS and have been approved for sugery. My OS

initially put in a request for both jaws and they approved the lower

only. When I went back to see him he said I would definately have to

have both jaws done so put in a repeat request and assured me that it

would go through no problem (though I'm still anxiously waiting...)

As far as I know the PPO plan will cover everything. If you have a

different plan though it might not.

Jo

> I've asked about Blue Cross Blue Shield of MA a few months ago, but

> I'll try again. Anyway, I have BCBS of MA for insurance and I'm just

> wondering if anyone has gotten lower and/or upper jaw surgery approved

> through them? I'm currently appealing right now, but I'm wondering if

> there are any tricks to this insurance game (especially with this

> company). Thanks!

>

> -

[Guest guest]

Hi ,

I don't have BCBS, but I have United and they have been a pain. I sent

in 2 requests from different doctors (I decided the first doctor wasn't

worth my time and money). They denied both claims. I called the

company who sells my employer the insurance policy and they called

United and emphasized that this is not cosmetic surgery and I just got

a letter yesterday saying that I had been approved (of course, there

was some small print I need to get clarified)!

Also, a co-worker has had the surgery using BCBS and the way he got his

approved after a couple of denial was to call the CEO of BCBS

directly. I don't know how he found the number, but it worked. He

swears by it! You might try it, it's worth a shot.

Amy

> I've asked about Blue Cross Blue Shield of MA a few months ago, but

> I'll try again. Anyway, I have BCBS of MA for insurance and I'm just

> wondering if anyone has gotten lower and/or upper jaw surgery

approved

> through them? I'm currently appealing right now, but I'm wondering

if

> there are any tricks to this insurance game (especially with this

> company). Thanks!

>

> -

[Guest guest]

I have BCBS Federal, and I am still waiting on an

approval from them. I will let you know what they

say. What type of surgery are you having?

Austria

--- amygtcheer <no_reply > wrote:

> Hi ,

>

> I don't have BCBS, but I have United and they have

> been a pain. I sent

> in 2 requests from different doctors (I decided the

> first doctor wasn't

> worth my time and money). They denied both claims.

> I called the

> company who sells my employer the insurance policy

> and they called

> United and emphasized that this is not cosmetic

> surgery and I just got

> a letter yesterday saying that I had been approved

> (of course, there

> was some small print I need to get clarified)!

>

> Also, a co-worker has had the surgery using BCBS and

> the way he got his

> approved after a couple of denial was to call the

> CEO of BCBS

> directly. I don't know how he found the number, but

> it worked. He

> swears by it! You might try it, it's worth a shot.

>

> Amy

>

>

> > I've asked about Blue Cross Blue Shield of MA a

> few months ago, but

> > I'll try again. Anyway, I have BCBS of MA for

> insurance and I'm just

> > wondering if anyone has gotten lower and/or upper

> jaw surgery

> approved

> > through them? I'm currently appealing right now,

> but I'm wondering

> if

> > there are any tricks to this insurance game

> (especially with this

> > company). Thanks!

> >

> > -

>

>

>

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[Guest guest]

Yes, I have BCBS of Mass. My surgery (upper/lower) was approved. My OS

wrote a letter discussing how my problem was completely functional and

not cosmetic (although I paid for my genio surgery out of pocket).

BCBS of Mass is supposedly very good about paying for these surgeries

when it is a functional problem.

Hope this helps you.

Willa

> I've asked about Blue Cross Blue Shield of MA a few months ago, but

> I'll try again. Anyway, I have BCBS of MA for insurance and I'm

just

> wondering if anyone has gotten lower and/or upper jaw surgery

approved

> through them? I'm currently appealing right now, but I'm wondering

if

> there are any tricks to this insurance game (especially with this

> company). Thanks!

>

> -

[Guest guest]

Hi,

We have BC/BS of RI and after appealing, and a personal phone call from our

surgeon discussing my daughter's sleep apnea, functional problems, pain, etc,

it was approved. The companies seem to always assume these surgeries are

cosmetic! Good luck!

[Guest guest]

I have BC/BS of Alabama, and I got my approval, today, without any

denials. Have you tried asking your OS what codes they're using.

I've heard that makes all the difference. Good luck!

Angel

> > I've asked about Blue Cross Blue Shield of MA a few months ago,

but

> > I'll try again. Anyway, I have BCBS of MA for insurance and I'm

just

> > wondering if anyone has gotten lower and/or upper jaw surgery

> approved

> > through them? I'm currently appealing right now, but I'm

wondering

> if

> > there are any tricks to this insurance game (especially with

this

> > company). Thanks!

> >

> > -

[Guest guest]

Hi ,

I have BCBS of Mass PPO. It took about 3 months to my approval letter.

I worked closely with my OS's office to make sure that they had sent

everything from x-rays, to model to the insurance company and I

followed up every couple of weeks to get updates with the ins.

company. I would also check with your employer's HR dept to see if

they could help you get the list of coverages and exclusions handbook.

The handbook I received showed that Orthognathic surgery was a covered

surgery if it was combined with orthodontics. I am 3 weeks Post-Op and

had both upper and lower jaw surgery. I am very happy with the results

and very glad I did it. You could also check out my photos to see my

before and after pictures.

Good luck and let me know if you need anything else.

Kay

> I've asked about Blue Cross Blue Shield of MA a few months ago, but

> I'll try again. Anyway, I have BCBS of MA for insurance and I'm

just

> wondering if anyone has gotten lower and/or upper jaw surgery

approved

> through them? I'm currently appealing right now, but I'm wondering

if

> there are any tricks to this insurance game (especially with this

> company). Thanks!

>

> -