Gunson Anthem Ins??

[puglover]

Hi All,

I am new to this site and am mainly posting because the admin says I have too or my account will be shut down. But anyways, I have a consult with Dr. Gunson in SB (luckily I live in SB) on Mar 21st and I am really nervous about price. I know he is out of network for me. Im not sure what I need yet as far as surgery but I know I have a receding lower jaw. I have seen other posts on there where anthem does not pay surgical fees...this really freaks me out.

Can anyone give me any advice?

Also....can I bring my boyfriend to the consult with me?

THANKS!

[Marisama]

No answer for you about insurance, but yes, you can bring your boyfriend. My wife came with me to my Gunson consult. Good luck!

[double jawbreaker]

I had a consult with Dr. Gunson several months back and my mom was able to listen in on the consult. Its good to have a second set of ears. I have Anthem as well. My insurance approved the surgery, however I'm still waiting to hear about the allowable amount. I've been warned that Anthem's allowable amount can be ridiculously low. I haven't received a confirmation on the amount yet. I'm keeping my fingers crossed that its a higher number than I'm expecting. If its not, I'll be posting here about appealing an allowable amount.

[puglover]

oh man. I don't know how I am going to be able to afford it the surgery if ins doesn't help a lot...so scary.

[CaliforniaKid]

even if ur insurance doesn't cover it, you can always file an appeal.

eventually you'll get some coverage.

arnett's team are very ruthless when it comes to insurance companies, they work really hard at helping patients get the care they need from companies that do their best to avoid ortho surgery.

gunson and arnett are easily the top surgeons in california by far. Hang tough, surgery is expensive.

Also remember the consult fee for Arnett is ~$400 so be prepared for that.

[ReoSity]

Also remember the consult fee for Arnett is ~$400 so be prepared for that.

It's actually 550 now.

[double jawbreaker]

California Kid, did you have surgery with either Dr. Arnett or Dr. Gunson? If so do you have before and after photos, or a blog to follow? I'm trying to track down others who have had surgery with Arnett/Gunson. Also I haven't received my allowable amount yet, but I'm preparing for less than more. How do you go about appealing the allowable amount? Thanks for any input.

[CaliforniaKid]

California Kid, did you have surgery with either Dr. Arnett or Dr. Gunson? If so do you have before and after photos, or a blog to follow? I'm trying to track down others who have had surgery with Arnett/Gunson. Also I haven't received my allowable amount yet, but I'm preparing for less than more. How do you go about appealing the allowable amount? Thanks for any input.

Not yet. There are a few posters here that have provided their own blogs with before/after pics from gunson/arnet.

here is one:

http://asmileconnectsus.blogspot.com/

Just search...http://archwired.com/phpbb2/search.php? ... mit=Search

I don't know a lot about the insurance process. Once you file a claim and they reject it (they usually do the first time), you can appeal it. A lot of insurances specifically exclude orthognathic surgery but there are ways to get around it.

It really depends on your insurance. After your consult you will speak with their insurance director who will explain all the costs associated with the surgery. They file the insurance claim. Since the consult is so expensive I suggest you write down all your questions ahead of time. They are very patient and the doctors spend a lot of time in their consults.

[puglover]

Thanks for the advice guys. My appointment is this Friday, I am very excited and nervous to hear what they have to say. And yeah I am aware of the $550 consult fee (hence why I have waited over a year to consult).

Does anyone have any suggestions about questions I should ask during the insurance portion of the consult. I'm in my early 20's, don't have a parent to go with me, never really dealt with ins/claims/allowables all of that on my own.

Also I have another consult scheduled with Dr. Kiken in SB, CA. Does anyone have any experiences with him? I wanted a second opinion/back up in case Dr. Gunson's price is out of the question (I know its my face but I don't feel like my situation is that unusual or special) or I don't like him, or feel uncomfortable. I would rather go with Gunson b/c he is more accredited....but we shall see.

THANKS!

[CaliforniaKid]

Thanks for the advice guys. My appointment is this Friday, I am very excited and nervous to hear what they have to say. And yeah I am aware of the $550 consult fee (hence why I have waited over a year to consult).

Does anyone have any suggestions about questions I should ask during the insurance portion of the consult. I'm in my early 20's, don't have a parent to go with me, never really dealt with ins/claims/allowables all of that on my own.

Also I have another consult scheduled with Dr. Kiken in SB, CA. Does anyone have any experiences with him? I wanted a second opinion/back up in case Dr. Gunson's price is out of the question (I know its my face but I don't feel like my situation is that unusual or special) or I don't like him, or feel uncomfortable. I would rather go with Gunson b/c he is more accredited....but we shall see.

THANKS!

arnett/gunson can charge double or triple the usual rate.

but..u get what you pay for. in one of their offices you will see about 100 before/after collections plastered all over the wall.

if your consultation isn't in the office just ask to see the pictures.

i met with so many different surgeons and arnett just made everything seem right. quite pricey though.

[double jawbreaker]

Puglover, good luck on Friday. During my consult with Dr. Gunson I was too busy absorbing the medical aspects that I didn't prepare any questions about insurance for his financial advisers. The good news is that I didn't have to. Dr. Gunson and his staff are great about returning emails. I've bombarded both Natasha, the financial adviser, and Lena, medical coordinator with questions. They have been amazing about answering everything. I regret not inquiring about more before and afters photos, although there were several pictures lining the walls in the consult room. Now I'm frantically searching for blogs, and inquiring on messages boards about people who have had the surgery with Dr. Gunson to view some before and after photos. Good luck Puglover. Let us now how it went when you get back.

[puglover]

Just got back from the consult. WOW that was a lot more intense than I was expecting. Dr. Gunson was amazing though. So I need upper and lower jaw surgery. My airway is very small and my joints are pretty messed up. I asked him how severe my case was and he said for him its moderate but for the general orthognathic community its very severe, which scares me. I don't feel comfortable going to anyone else now. If insurance doesn't help me (which Natasha is going to work on) its 45K......

I don't know what I am going to do. I have an appointment with Dr. Kiken (in SB) next week. We'll see after that.

[double jawbreaker]

Puglover, its good to hear your consult went well. Did you get a chance to look at the before and afters? RYANvaughn did you have are are you having the surgery with Dr. Gunson? I'm still relatively new to this site so you might have mentioned it before. If so do you have a blog or pictures to view?

[Marisama]

No, I haven't had surgery yet. I'm still waiting on insurance approval. My case is borderline medically necessary, so I'm hoping for the best.
I will definitely start a blog when I start treatment and I'll be sure to post it here.

[puglover]

someone sent me a pm, when I click to read it it says "You are not authorised to read private messages."

Does anyone know what i should do to become "authorised" (haha its spelled the English way) They FAQ section on here didnt really help. or you can just email me at angsauve @ gmail com