Re: Dr. West says I'm ready!

[Guest guest]

Hi Luna,

That is amazing news! You have had what most people are secretly

hoping for - a short time in braces prior to surgery! Way to go!

And having the surgery in the summer break will probably give you a

better chance of healing well before you have to go back to school.

I am really happy for you.

I am pretty sure you will be able to work out the insurance

nightmare. Are you changing plans at a time that is open enrollment

in your employment? Then there should be no problem with it being

covered, but you will probably have to have it preauthorized first

too. Dr West will send a great letter for you. He sent me a copy

of the one he sent to my insurance, and it was amazing. I am

sending you good luck wishes on this AND crossing my fingers! lol

Be sure to advocate for yourself too.

I know Dr West said they would not proceed until they had WRITTEN

authorization from my insurance. I think they will be able to help

you a lot once you get the plan changed. If you can give them lead

time, it will probably have a better chance of making a smooth

transition.

But it is great that you had a minimal amount of time in the preop

braces! I hope that holds for me too!! lol

Great news!

Fran

> Diane, Fran et al., I met Dr. West on Monday. Everything went fine,

> and he and my orthodontist pronounced me ready for the surgery

(lower

> adv.) this summer. I had guessed that might be the case, as my

teeth

> moved really fast. I got the braces on in October, and they had

> projected I'd be ready after a year, but I would've had to wait

until

> winter break from school.

>

> Now we're shooting for July, but I have a few obstacles to overcome

> first. The biggest is coming up with the money ahead of time. I'm

> hoping my bank will give me a loan. I'm also concerned because our

new

> insurance plan year starts July 1 AND we're switching providers. I

got

> preauth from BCBS a while back, but now that we're switching I

don't

> know what will happen. I've been asking and asking -- my HR person,

> the insurance folks -- and everybody says " It will PROBABLY be

> covered, " but nobody can say for sure. I don't know what to do. And

> since I'll be doing the insurance billing myself, I'm pretty

nervous.

> Advice welcome!

>

> Also, my friend who had offered to come with me in the winter can't

> get away from her business in summer, so I've asked another friend,

> who wants to, but has to make sure her business is covered, too.

>

> So, that's about it. I'm pretty excited, but a little in shock,

too.

> This is feeling very real all of a sudden!

>

> Luna

[Guest guest]

Hey Fran, thanks for the reply. Yeah, I was in serious pain the first

couple weeks I was in braces, and later figured out why when my teeth

straightened in less than two months. But I'm not complaining now ....

As for insurance, we're in open enrollment right now, but the new

period begins July 1. That's when we switch from Blue Cross to

Allegiance as a provider. Everyone says it's still the " same plan " --

self-funded by my employer -- so the benefits " should " be the same --

but no one's willing to say so in writing. And since the new plan year

begins July 1, and my surgery will probably be in July, I'm not sure

whether there will be time to get a new authorization? Dr. West did

write a letter and we received a pre-auth from BCBS, but that was

about two years ago. Anyway, it's all confusing, but I think it will

probably work out.

I talked with my bank and it looks like I'll be able to get the loan I

need. I still have to fill out the paperwork and go through the

application process before I know for sure, though.

Anyway, it's all very exciting. One thing that was a little bit of a

bummer was that Dr. West said that my prominent chin bump was flesh,

not bone, so there wasn't much that could be done to minimize it. He

did say the jaw advancement would help a little with the appearance.

But it sounds like it won't be as dramatic as I was hoping for. Oh

well. Any improvement is better than what I have now. I hope.

Luna

> > Diane, Fran et al., I met Dr. West on Monday. Everything went fine,

> > and he and my orthodontist pronounced me ready for the surgery

> (lower

> > adv.) this summer. I had guessed that might be the case, as my

> teeth

> > moved really fast. I got the braces on in October, and they had

> > projected I'd be ready after a year, but I would've had to wait

> until

> > winter break from school.

> >

> > Now we're shooting for July, but I have a few obstacles to overcome

> > first. The biggest is coming up with the money ahead of time. I'm

> > hoping my bank will give me a loan. I'm also concerned because our

> new

> > insurance plan year starts July 1 AND we're switching providers. I

> got

> > preauth from BCBS a while back, but now that we're switching I

> don't

> > know what will happen. I've been asking and asking -- my HR person,

> > the insurance folks -- and everybody says " It will PROBABLY be

> > covered, " but nobody can say for sure. I don't know what to do. And

> > since I'll be doing the insurance billing myself, I'm pretty

> nervous.

> > Advice welcome!

> >

> > Also, my friend who had offered to come with me in the winter can't

> > get away from her business in summer, so I've asked another friend,

> > who wants to, but has to make sure her business is covered, too.

> >

> > So, that's about it. I'm pretty excited, but a little in shock,

> too.

> > This is feeling very real all of a sudden!

> >

> > Luna

[Guest guest]

Hi Luna,

WOuld it be possible to have Dr West's office contact your current

carrier to re-pre-authorize it? I know from my insurance which is

also an employer paid self funded program, they only maintain pre-

authorization for 6 months from the date it is issued. I don't know

if that is a fairly standard practice or not, but it would be a good

idea to have a fresh pre-authorization on file. That should make it

easier to have a new one with the new provider. You could call Dr

West's office and see if that would be possible, or if your pre-

authorization had a valadation date specified. Just a thought.

Fran

> > > Diane, Fran et al., I met Dr. West on Monday. Everything went

fine,

> > > and he and my orthodontist pronounced me ready for the surgery

> > (lower

> > > adv.) this summer. I had guessed that might be the case, as my

> > teeth

> > > moved really fast. I got the braces on in October, and they had

> > > projected I'd be ready after a year, but I would've had to

wait

> > until

> > > winter break from school.

> > >

> > > Now we're shooting for July, but I have a few obstacles to

overcome

> > > first. The biggest is coming up with the money ahead of time.

I'm

> > > hoping my bank will give me a loan. I'm also concerned because

our

> > new

> > > insurance plan year starts July 1 AND we're switching

providers. I

> > got

> > > preauth from BCBS a while back, but now that we're switching I

> > don't

> > > know what will happen. I've been asking and asking -- my HR

person,

> > > the insurance folks -- and everybody says " It will PROBABLY be

> > > covered, " but nobody can say for sure. I don't know what to

do. And

> > > since I'll be doing the insurance billing myself, I'm pretty

> > nervous.

> > > Advice welcome!

> > >

> > > Also, my friend who had offered to come with me in the winter

can't

> > > get away from her business in summer, so I've asked another

friend,

> > > who wants to, but has to make sure her business is covered,

too.

> > >

> > > So, that's about it. I'm pretty excited, but a little in

shock,

> > too.

> > > This is feeling very real all of a sudden!

> > >

> > > Luna

[Guest guest]

Fran, I think I will do that. Even if we're switching, it can't hurt

to have a fresh pre-auth from the old provider. I'll call West's

office tomorrow. Thanks! Luna