Re: Insurance Question/ Surgery Prep. Help

[Guest guest]

Hi joidishelle,

First of all - way to go!! That is great about being preapproved!

That must be a big burdon lifted from your shoulders.

I am pre op so cannot really help you with the post op tips, sorry!

But I would suggest that you contact your OS office manager, or the

person in the office who handles the insurance claims. They can get

the dates of coverage cleared up with a phone call. And then they

can let you know. I am thinking that most OS charge a procedural

fee that includes the surgery and post op visits for the same

procedure. That is how many procedures are covered. At least with

my insurance. If that is the case, the post op visits you have with

the OS would be covered by the up front fee the insurance pays for

the procedure. But I am not sure if all insurances cover procedures

and post op visits this way. The OS office manager would be able to

tell you this also.

And the OD visits post op are usually included in the initial OD

fee, at least in the region I live in (near Seattle). So unless you

have a secondary surgery (like I am having a separate rhinoplasty

necessary because of the repairs they are making with the jaw

surgery), or secondary dental work, most of the fees should be

included.

Let us know what you find out about that. It would be helpful to

know if this is standard or if it is something newbies would want to

ask upfront. Good question!

Hugs,

Fran

> Hello everyone

>

> I have not posted in a while but I have still been reading and

> keeping up with everyone's developments. I had major issues with

my

> insurance company, but because I am in college and on both my

> parents' insurance plans, when my mom's insurance failed

> (UnitedHealthcare) I was able to try my dad's(BC BS of TN.) and

thank

> the lord my predetermination has been approved.

>

> I now have 2 concerns:

>

> 1. What should I do to prepare for the surgery? B/C I was

originally

> scheduled to have surgery in April I already have my Zip N Squeeze

> products, but I wanted advice about other things such as exercise,

> recipe ideas, and helpful hints. I will be having my lower jaw

> rotated to the right 7mm and moved back 2mm and I will have the 3-

> piece upper and my upper jaw moved forward 2mm so I may not be

> chewing for a while

>

> 2. My dad's company has just been bought out and I am not sure if

his

> insurance coverage will change. They have open enrollment starting

in

> the first few weeks of December and my procedure is scheduled for

> Dec. 12th. The current insurance that we have did not become

> effective until Jan. 10th 2005 and I think that the coverage is

for a

> full year( until 1/10/06) but I wanted to know if anyone had any

> experience with insurance changing in right before or in the

middle

> of a procedure? What should I expect to happen?

[Guest guest]

I work as a consultant for human resources and

insurance. If your father's company changes insurance

companies within 30 days of your surgery you can

request transition coverage so if they change

insurance companies, the new insurance will honor your

surgery if it was already scheduled and approved.

They don't advertise this so your father needs to be

prepared to go to his HR dept. and let them know and

specifically ask about transition coverage.

Transition coverage is usually extended to surgeries

and maternities in their 3rd trimester. Hope that

helps.

Kim

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