Metal Mouth Message Board

Apparently my insurance excludes orthognathic surgeries so they won't cover a dime. So my family and I will be paying straight up dineros.

I received the pre-surgical deposit bill, which is about 41,000k. Is this pretty average for Arnett/Gunson? It's a double jaw surgery. In addition, the hospital bill is 10k+. Not sure if there is a difference between the "assistance" surgeon and the anesthesiologist. If there isn't that's another 9k.

So ballpark figure, 55k? The real problem is I was told the cost might be more or less depending on the next exam, which occurs like a week before the schedule surgery. But we have to take the money out months in advance, so if it's more that will be a problem. Anyone else have this issue?

I know Arnett/Gunson are the best. The quotes I got from other surgeons were 20-25k so I hope this works out.

Thoughts?

41k for surgical fees sounds about right for them if your case isn't too complicated, mine is 39k and I'll be paying out of pocket as well unfortunately!

I'm not sure about the fee's changing, it seem pretty unprofessional of them to substantially increase the cost a week before surgery. Especially since the deposit is due 2 months in advance. I'd contact Natasha if you're really worried.

I'm jealous of you both! I consulted with Arnett in July. I will be surgery ready come June or July but my insurance (Anthem Blue Cross) is only agreeing to pay $3,000 since Arnett is out-of-network. My family would be taking care of the rest for me but we are having trouble justifying the $42k out of pocket fees. What are your opinions on finding somebody in-network? I've seen two surgeons in the last few months and actually got a good feeling from the once I most recently saw. He does about 20 jaw surgeries per year, which is actually pretty high. From what I've found anybody who does orthognathic surgery with any regularity and is highly skilled does NOT contract with medical insurance (arnett, wolford, etc.). The ones who are trained for it and are in-network are trained OMFS's but do primarily wisdom teeth and implant with a few jaw surgeries in between.

Thoughts? I'm OK with not seeing Arnett so long as the surgeon I find is skilled. We're talking about $40,000 here!

Zach

@Reo

wouldn't say my case is complicated, but certainly not standard. the ~40,000 is just the deposit surgical fee.

It doesn't include the hospital fee + hotel which could be 13-15k. problem is insurance covers ZERO. not one penny. how can they do that? such an injustice. I'll be diverting some of the money from my students loans to cover the costs of the surgery. and maybe prostitute myself until september.

@new

at this point i wouldnt even consider switching out surgeons since my ortho and gunson/arnett have already worked out a treatment plan. funny thing is that you really only see the surgeon once before surgery - the consultation. all medical info is handed off between the ortho and the arnett/gunson office.

I just want to make sure everything is 100% and not show up for surgery and hear, "hmmm...well, the models didn't show this.."

I know Arnett does less surgeries than gunson, but between them both I'm told they do more than three a week. So they are super experienced. That's why they charge premium.

CaliforniaKid wrote:@Reo

wouldn't say my case is complicated, but certainly not standard. the ~40,000 is just the deposit surgical fee.

It doesn't include the hospital fee + hotel which could be 13-15k. problem is insurance covers ZERO. not one penny. how can they do that? such an injustice. I'll be diverting some of the money from my students loans to cover the costs of the surgery. and maybe prostitute myself until september.

I'm in the same boat, the 39k is the surgical deposit only. Some people's surgical fee's are 60-70k+ so we're "lucky" in that regard.

but have you met with them more than once? I just feel like another "meeting" a few months before the surgery would be helpful. I don't even know what the surgery is specifically called, just a lot of checked off boxes.

No I haven't but I plan to sometime before the surgery, there are a few details about my surgical plan that I need to discuss with Gunson. I understand your concern though, not seeing your surgeon until just before the surgery is a bit strange.

As far as what your surgery is called, didn't you or your ortho receive the surgical and orthodontic plan? If not call the office and request a pdf of it, your entitled to know what exactly is happening to your face.

ReoSity wrote:No I haven't but I plan to sometime before the surgery, there are a few details about my surgical plan that I need to discuss with Gunson. I understand your concern though, not seeing your surgeon until just before the surgery is a bit strange.

As far as what your surgery is called, didn't you or your ortho receive the surgical and orthodontic plan? If not call the office and request a pdf of it, your entitled to know what exactly is happening to your face.

surgeons were not sure originally. Arnett/Gunson wanted to know how the ortho treatment would work out before deciding on a final treatment plan. The boxes list the numerous procedures done (chin aug, upper lower jaw, grafts, etc..etc..) but nothing too specific.

Should I first email Lena or what? Talk to my ortho? My MAIN concern is that the form inferred that the cost may be more or less on the day of the surgery. Did your form say this? Problem is, my family and I will be taking out a series of loans and dipping into personal savings to cover the surgery.

We knew this from the get-go. But if surgeons suddenly decide a new surgical approach is necessary, we won't have the money to cover it. Has anyone ever met with arnett/gunson a second time prior to surgery?

Wow. Just wow. If I was told my bill was going to be $50k+, I would have said "no thanks."

I guess each case (and each hospital) is dramatically different. My estimate (without insurance paying) for a 3-piece LeFort and BSSO/genio, including hospital stay, is $15-17k. And this is not a rookie; my surgeon is a professor at the dental school who does approx. 100-150 orthognathic surgeries a year and surgery will be performed at the medical school's hospital.

While you may be really comfortable with your current oral surgeon, there has to be some surgeon with good hands, somewhere, that doesn't charge so much... surely your ortho could communicate a treatment plan with another surgeon if you were to choose one. It'd be financially worth it to search far and wide for another one; even a flight across the country would be a bargain in return for a bill even a few thousand lower.

Even though insurance doesn't cover your operation, if you use an oral surgeon in the insurance company's network, you'll pay the rates negotiated by insurance, which are often dramatically lower than "rack" rates.

@sir

problem is I met with half a dozen surgeons who all gave me completely different diagnoses.

then i hear about arnett/gunson and their world-class status, and decide to see them. it just made total sense. i dont hear about anyone leaving their office and feeling disappointed about the insight, though i imagine many are frustrated over the costs.

znewton wrote: From what I've found anybody who does orthognathic surgery with any regularity and is highly skilled does NOT contract with medical insurance (arnett, wolford, etc.). The ones who are trained for it and are in-network are trained OMFS's but do primarily wisdom teeth and implant with a few jaw surgeries in between.

Thoughts? I'm OK with not seeing Arnett so long as the surgeon I find is skilled. We're talking about $40,000 here!

Zach

Hi Zach,
I don't think that statement is necessarily true. My OS has been around for quite some time (he's probably about ready to retire) and while he does do wisdom teeth, he specializes in major reconstructive maxillofacial surgery and that's clearly where his passion lies. People travel from all over (World) to have him perform their surgeries.... which is why I felt so comfortable having him do mine. He helped develop the first university sponsored curriculum in orthognathic surgery for the departments of orthodontics and oral and maxillofacial surgery at Northwestern University here in Chicago a loooong time ago. Every person I've come across who knows him always makes statements like "wow, have you seen the work he has done?" He's known in Chicagoland as one of the "best in the biz" for quite complicated jaw procedures and happens to be in-network with several insurance providers including mine. His costs would have been quite steep, comparable to this Dr. Arnett.

So, I guess what I am getting at is that there are many top-notch surgeons out there specializing in orthognathic surgery, who are in-network. They may be far and few inbetween... but they are out there. Do some research, and you may be able to find a fantastic surgeon who will accept your insurance. It's not worth it to compromise and get a poor outcome for going with a non-experienced surgeon, but on the other hand, (in my opinion), it's not worth it to fork out SO much money when surgeons comparable to Arnett/Gunson are out there and do accept insurance.

Good luck!

comparable to arnett and gunson?

hard to prove. all they do is surgeries.

[/quote]


So, I guess what I am getting at is that there are many top-notch surgeons out there specializing in orthognathic surgery, who are in-network. They may be far and few inbetween... but they are out there. Do some research, and you may be able to find a fantastic surgeon who will accept your insurance. It's not worth it to compromise and get a poor outcome for going with a non-experienced surgeon, but on the other hand, (in my opinion), it's not worth it to fork out SO much money when surgeons comparable to Arnett/Gunson are out there and do accept insurance.

Good luck! [/quote]

This is an interesting point. I am planning to have surgery with Gunson as well. I wonder if there are other surgeons in my insurance network that are just as qualified. If anyone has any insight on this, I would greatly appreciate it.

Print out a list of the in-network OMFS's in your area and ask your orthodontist if he knows any of them that do decent Orthognathic surgery. Where I live (the Raleigh/Durham/Chapel Hill, NC area), in-network, there are two professors at the UNC dental school that regularly do them, one doctor at Duke (who's also an adjunct at the dental school), and one in private practice that my Perio recommended.

By the way, I'm on Anthem also... so it can't be that Anthem is a bunch of cheapskates that can't attract OMFS's.

Hey CaliforniaKid,

Can I send you a pm?