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Okay...so it has been since January that my pre determination has been

sitting on the desk of United Healthcare and still keep getting the run

around... Here is my question.

I am having a bone graft done followed by several implants. Can anyone

tell me if they have had a bone graft done and what the cost was, as

well as the assistant surgeon's fee??? This would be of great help to

me. She is charging me $4500 simply for the bone graft and a friend of

mine told me the coverage is for $778. Please help!!!!

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Hiya,

I don't know what any of your costs should be but I will offer this... I had

United as well.

They are notorious for " losing " paperwork, giving you incorrect info and

delaying things

until you miss deadlines.

Keep good notes and make it your business to be on top of them... no-one there

is

looking out for you. I eventually got full coverage and was on a first name

basis with the

person who made sure my claim went right through the system.

Good Luck!

Tova

> Okay...so it has been since January that my pre determination has been

> sitting on the desk of United Healthcare and still keep getting the run

> around... Here is my question.

> I am having a bone graft done followed by several implants. Can anyone

> tell me if they have had a bone graft done and what the cost was, as

> well as the assistant surgeon's fee??? This would be of great help to

> me. She is charging me $4500 simply for the bone graft and a friend of

> mine told me the coverage is for $778. Please help!!!!

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Hey Tova,

I was just thinking the other day that we haven't heard much from you

lately. How are you doing?

Diane, Oregon

_____

From: orthognathicsurgerysupport

[mailto:orthognathicsurgerysupport ] On Behalf Of teezestuff

Sent: Wednesday, May 11, 2005 7:02 PM

To: orthognathicsurgerysupport

Subject: Re: Insurance Question

Hiya,

I don't know what any of your costs should be but I will offer this... I had

United as well.

They are notorious for " losing " paperwork, giving you incorrect info and

delaying things

until you miss deadlines.

Keep good notes and make it your business to be on top of them... no-one

there is

looking out for you. I eventually got full coverage and was on a first name

basis with the

person who made sure my claim went right through the system.

Good Luck!

Tova

> Okay...so it has been since January that my pre determination has been

> sitting on the desk of United Healthcare and still keep getting the run

> around... Here is my question.

> I am having a bone graft done followed by several implants. Can anyone

> tell me if they have had a bone graft done and what the cost was, as

> well as the assistant surgeon's fee??? This would be of great help to

> me. She is charging me $4500 simply for the bone graft and a friend of

> mine told me the coverage is for $778. Please help!!!!

_____

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Guest guest

Diane,

Thanks for thinking of me! I've been super busy and try to skim the emails but

often don't

have time... Plus, just as I was getting back on my feet, my computer started

acting funny

and it's been in and out of the shop for the last 2 months! It's been making me

nuts. I

posted a recap of thel last few months but i'm happy to let you know about

anything

specific... it was certainly a journey, this whole crazy process!

Best, Tova

> > Okay...so it has been since January that my pre determination has been

> > sitting on the desk of United Healthcare and still keep getting the run

> > around... Here is my question.

> > I am having a bone graft done followed by several implants. Can anyone

> > tell me if they have had a bone graft done and what the cost was, as

> > well as the assistant surgeon's fee??? This would be of great help to

> > me. She is charging me $4500 simply for the bone graft and a friend of

> > mine told me the coverage is for $778. Please help!!!!

>

>

>

>

>

> _____

>

>

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Guest guest

Tova....

Quick question.. was your doc in or out of network? It is very hard

to find in network omf surgeons in my area... what a pain!!!

Beth

> > Okay...so it has been since January that my pre determination has

been

> > sitting on the desk of United Healthcare and still keep getting

the run

> > around... Here is my question.

> > I am having a bone graft done followed by several implants. Can

anyone

> > tell me if they have had a bone graft done and what the cost was,

as

> > well as the assistant surgeon's fee??? This would be of great

help to

> > me. She is charging me $4500 simply for the bone graft and a

friend of

> > mine told me the coverage is for $778. Please help!!!!

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  • 11 months later...
Guest guest

Make sure the orthotics company uses the code for " durable medical

equipment " its the same code they would use to code a

wheelchair,prosthetcs, etc. Our insurance does not cover foot

orthotics in relations to diabetes treatment, etc. However, they did

cover the shoes/bar and replacement shoes since as long as the code

is the equivalent to durable medical equipment. If this doesn't

work, find out how to submit an appeal and get a doctor's letter

explaining the course of treatment and explanation for the shoes/bar

(ie medical necessity). WE did this(ie the letter) as a just in case

and it has come in handy as it is in our records and they no longer

hold up payment.

HTH,

Kathleen

mom to david bcf fab 12/7

>

> I have never had to use insurance before this pregnancy and boy

has it been

> fun (ha :)

>

> My Riley Jade (born 1-12-06 bilateral club feet) got her Markell

boots and

> bar in March. I just found out that our insurance does not

cover " Orthopedic

> shoes, foot orthotics, or other devices to support the feet " .

What? This

> seems a little crazy to me because if she doesn't have the shoes

and bar her

> feet would relapse and they would have to pay for numerous

surgeries etc.

> (Preaching to the choir) Is this typical and does anyone else

have any tips on

> disputing or getting insurance to pay? I had heard the

's weren't

> covered but didn't realize the Markells (sp) were not.

>

>

>

>

>

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