Hey so what insurance do you guys have? anyone else ready to go and strangle everyone at their insurance company?
Mine didn't preapprove the procedure until the day before due to a paperwork mishap. My surgeon told me they would cover 100% of the hospital charges and the BSSO (not the genio which I expected).
Well so far, all Ive gotten is a note from them that they'll only cover $500 out of the $1600 anesthesia bill (the anesthesiologist charges separate from the hospital). Not only do I not particularly have an additionl $1100 laying around, but it makes me worried about the $13000 hospital bill I got and how much they will cover out of that!
How much did everyone's insurance cover for?
October buddies
Moderator: bbsadmin
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Broadway Bill
- Posts: 103
- Joined: Tue Sep 07, 2010 4:17 pm
Izzy,
My insurance covered it all but $1900. That part they did not pay was the pre/post-op work and the $400 deductible. All in all, I was really happy with my insurance (sorry!).
I have great insurance though. I got my policy as a result of my family buying a lot of stock in Anthem (many many many years ago), and by all accounts it is an incredibly good policy.
From what little I know, if you fight them for a while, they will likely pay what they should.
Good luck!! Hope it works out!
My insurance covered it all but $1900. That part they did not pay was the pre/post-op work and the $400 deductible. All in all, I was really happy with my insurance (sorry!).
I have great insurance though. I got my policy as a result of my family buying a lot of stock in Anthem (many many many years ago), and by all accounts it is an incredibly good policy.
From what little I know, if you fight them for a while, they will likely pay what they should.
Good luck!! Hope it works out!
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cocomecrazy
- Posts: 33
- Joined: Sat Oct 09, 2010 12:06 pm
Woahh you should argue with them that they should charge you for whatever they initially said first!!! That they're gonna cover 100% (because your surgeon said so)Izzy1979 wrote:Hey so what insurance do you guys have? anyone else ready to go and strangle everyone at their insurance company?
Mine didn't preapprove the procedure until the day before due to a paperwork mishap. My surgeon told me they would cover 100% of the hospital charges and the BSSO (not the genio which I expected).
Well so far, all Ive gotten is a note from them that they'll only cover $500 out of the $1600 anesthesia bill (the anesthesiologist charges separate from the hospital). Not only do I not particularly have an additionl $1100 laying around, but it makes me worried about the $13000 hospital bill I got and how much they will cover out of that!
How much did everyone's insurance cover for?
I have Kaiser, I only had to pay about 6 grand
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mamaneedsanewjaw
- Posts: 139
- Joined: Fri Mar 12, 2010 9:06 am
Izzy- I have Anthem BCBS and I got a pre-approval for my surgery. So far they have paid the surgeon, anesthesia, pre-op and post op visits but not the bill from the hospital. It is STILL PENDING to the tune of $33,000!!! But I think it is an error on the hospitals side because they have my date of service as Sept 27th and my surgery was Oct 11th. I am a bit concerned because I was preapproved for a 23 hour hospital stay and ended up being admitted and staying two nights, three days because my blood pressure was so low. Surely they don't expect me to go home with a blood pressure of 80/55 but with insurance companies, who knows. I also had a $3,000 deductible I had to pay for but after that everything is supposed to be covered.
Good luck!!
Good luck!!
@mama: Anthem is slow on paying any bill that is over $10,000 I've noticed. I'm sure they will pay in due time, but they may ask you to get an "approval" for your extended hospital stay. I had to do this my first surgery. You can either get it from your oral surgeon (the admitting doctor) or the hospital's utilization manager.
Also, just so everybody is aware, when you stay in network there is going to be a huge discrepancy between the amount charged and the amount paid by insurance. This is because of negotiated discounts. You are not responsible for the charges in excess of the allowed negotiated amount, and it should explain that in your EOB.
-Chicago29
Also, just so everybody is aware, when you stay in network there is going to be a huge discrepancy between the amount charged and the amount paid by insurance. This is because of negotiated discounts. You are not responsible for the charges in excess of the allowed negotiated amount, and it should explain that in your EOB.
-Chicago29
Had to share my just extremely unpleasant experience
I was brushing my teeth and noticed a piece of suture on my lower gum (where they did incision for genioplasty). My surgeon has been pulling those out and I tried to pull the little bit I saw with tweezers. BAD idea. I barely pulled and it hurt like HELL and my lower lip immediately tripled in size. The pain stopped right away but the sweeling makes me a little worried. Good thing I see the surgeon tomorrow morning! Note to all - leave well enough alone!
As far as insurance... I have BlueChoice (BlueCross/BlueShield) and they are pretty renowned to suck so I'm sure I'll have to fight them every penny. Sigh.
I was brushing my teeth and noticed a piece of suture on my lower gum (where they did incision for genioplasty). My surgeon has been pulling those out and I tried to pull the little bit I saw with tweezers. BAD idea. I barely pulled and it hurt like HELL and my lower lip immediately tripled in size. The pain stopped right away but the sweeling makes me a little worried. Good thing I see the surgeon tomorrow morning! Note to all - leave well enough alone!
As far as insurance... I have BlueChoice (BlueCross/BlueShield) and they are pretty renowned to suck so I'm sure I'll have to fight them every penny. Sigh.
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Broadway Bill
- Posts: 103
- Joined: Tue Sep 07, 2010 4:17 pm
Izzy:
I did the same thing last week! My surgeon had told me that it looked like all of the sutures had dissolved. Then, I spotted an inch long (or so) little piece of stitch coming from the messed up area on my left cheek. So, I reached in and grabbed the little bastard! It hurt something awful, and it pulled the suture point into a pucker! Luckily, no swelling, but still...ouch!
And, last night, I really got to exploring around in there with my tongue, and I noticed that I also have some sutures still hanging in there along my lower gumline. At least I learned from my earlier trauma and left them alone. I love those rare moments when the bands come off and I can just let my tongue walk all around in my mouth...it's like exploring an alien planet!
I did the same thing last week! My surgeon had told me that it looked like all of the sutures had dissolved. Then, I spotted an inch long (or so) little piece of stitch coming from the messed up area on my left cheek. So, I reached in and grabbed the little bastard! It hurt something awful, and it pulled the suture point into a pucker! Luckily, no swelling, but still...ouch!
And, last night, I really got to exploring around in there with my tongue, and I noticed that I also have some sutures still hanging in there along my lower gumline. At least I learned from my earlier trauma and left them alone. I love those rare moments when the bands come off and I can just let my tongue walk all around in my mouth...it's like exploring an alien planet!
yeah I finally feel everybody's pain as far as bands... the first 4 weeks I just had to wear some at night and they weren't too bad, but now my orthodontist put really uncomfortable ones that I have to wear around the clock. A straw fits in between so I've pretty much gone back to liquids so to not have to take them off all the time. And my teeth hurt pretty bad today. Ahhh can't wait for all this to be done with!
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ColoradoGirl
- Posts: 150
- Joined: Sun Jan 17, 2010 12:01 am
- Location: Santa Barbara CA
Stupid bands, and stupid sutures. I've been slacking on the bands (ha, ha) for a few days now...only changing them once a day.
Broadway Bill--ha! Totally like exploring an alien planet.
My latest obsession is with gum recession. (That's kind of a catchy sentence, actually). The gumline on both of my lower 4's is waaaaaay down near the lip area, and those two teeth hurt, especially around the gumline. It's weird, though, because this is the first feeling to return on the lower jaw, so I feel like I have these islands of tingly-sensitive-pain on each side surrounded by seas of numbness. Furthermore, I don't have sensation on the outside of my chin yet, but when I touch my chin I can feel *through* it onto the teeth in question. I'm scared to touch those teeth with the stupid hook for the elastics b/c I don't want to cause further recession...of course, those two teeth are major anchor points for elastics. Bleh.
Broadway Bill--ha! Totally like exploring an alien planet.
My latest obsession is with gum recession. (That's kind of a catchy sentence, actually). The gumline on both of my lower 4's is waaaaaay down near the lip area, and those two teeth hurt, especially around the gumline. It's weird, though, because this is the first feeling to return on the lower jaw, so I feel like I have these islands of tingly-sensitive-pain on each side surrounded by seas of numbness. Furthermore, I don't have sensation on the outside of my chin yet, but when I touch my chin I can feel *through* it onto the teeth in question. I'm scared to touch those teeth with the stupid hook for the elastics b/c I don't want to cause further recession...of course, those two teeth are major anchor points for elastics. Bleh.
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mamaneedsanewjaw
- Posts: 139
- Joined: Fri Mar 12, 2010 9:06 am
Coloradogirl- my teeth are super sensitive too. I have a hard time telling if I am starting to get a little feeling back in my chin or if I am poking at it so hard that I am assuming I am feeling something, if that makes any sense.
@chicago- thanks for the info on Anthem. Hopefully they will write that check soon!
I have another post-op with my surgeon tomorrow and a quick trip to the ortho to get a hook placed. Yeah- a six hour trip for two short appointments. UGGGGG
@chicago- thanks for the info on Anthem. Hopefully they will write that check soon!
I have another post-op with my surgeon tomorrow and a quick trip to the ortho to get a hook placed. Yeah- a six hour trip for two short appointments. UGGGGG
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ColoradoGirl
- Posts: 150
- Joined: Sun Jan 17, 2010 12:01 am
- Location: Santa Barbara CA
Mama--yeah, totally. I keep thinking of the old joke: "Patient: Doc, it hurts when I do this <poke>. Doctor: well, don't do that!"
Very annoying that you have to drive that far. Ugh.
Also, on the subject of insurance woes: what you all are saying is encouraging, but I'm still a bit freaked out. I just got a bill from the hospital for SEVENTY-EIGHT THOUSAND DOLLARS. I think that's probably just about the amount I've spent in the last ten years (hey, I'm a student). I am dearly hoping it is a mistake, but...definitely getting up early tomorrow to call. I don't know what they'll do if they decide to collect...I have a lovely pair of Kate Spade shoes; I think they'll be first (and, um, last) on the auction block. My teeth and jaws must be worth quite a bit now: I hope they don't decide to repossess. Or maybe our set of bath towels has increased exponentially in value since we got them as a wedding gift?...heck, I'd throw in a bottle of shampoo!
Very annoying that you have to drive that far. Ugh.
Also, on the subject of insurance woes: what you all are saying is encouraging, but I'm still a bit freaked out. I just got a bill from the hospital for SEVENTY-EIGHT THOUSAND DOLLARS. I think that's probably just about the amount I've spent in the last ten years (hey, I'm a student). I am dearly hoping it is a mistake, but...definitely getting up early tomorrow to call. I don't know what they'll do if they decide to collect...I have a lovely pair of Kate Spade shoes; I think they'll be first (and, um, last) on the auction block. My teeth and jaws must be worth quite a bit now: I hope they don't decide to repossess. Or maybe our set of bath towels has increased exponentially in value since we got them as a wedding gift?...heck, I'd throw in a bottle of shampoo!
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Broadway Bill
- Posts: 103
- Joined: Tue Sep 07, 2010 4:17 pm
CG, I know exactly what you mean about the teeth hurting/gums receding/touching "through" the chin.
For me, it is my lower sevens. I can see that the gumline is just beat up around them, and I think I can feel it hurting/aching off and on all day, but the whole concept of "hurting" is off because of the numbness. But, like you, when I touch my chin or lower lip, there is a feeling of sensation (kind of an ache, but also sort of radiant and "wavy") in my teeth. It is so weird, and does not really hurt, per se, but it still drives me nuts and is kind of uncomfortable. I have been having odd tinglings and aches all around my lip and chin, though, which I guess is good since it probably means things are coming back.
I go see my surgeon on Tuesday (as of today it has been 4 weeks since surgery, which I can't believe!) and I am hoping to be given the all clear for soft foods. Getting pretty hungry over here! In fact, I created a new word to refer to my hungry--"hangry." Hangry is a cross between hungry and angry, and it aptly describes my current state!
Does anyone else expect some lasting dietary changes from this? For one thing, I am pretty certain I will be going back to being a vegetarian (well, fish only vegetarian) after this is done. I did not eat meat for years, and not eating any for the past month, I have realized that it is one thing I don't miss at all. The other thing is that I can really tell how much my stomach and, subsequently, my appetite have shrunk. I honestly feel "full" if I eat half a can of thin soup.
For me, it is my lower sevens. I can see that the gumline is just beat up around them, and I think I can feel it hurting/aching off and on all day, but the whole concept of "hurting" is off because of the numbness. But, like you, when I touch my chin or lower lip, there is a feeling of sensation (kind of an ache, but also sort of radiant and "wavy") in my teeth. It is so weird, and does not really hurt, per se, but it still drives me nuts and is kind of uncomfortable. I have been having odd tinglings and aches all around my lip and chin, though, which I guess is good since it probably means things are coming back.
I go see my surgeon on Tuesday (as of today it has been 4 weeks since surgery, which I can't believe!) and I am hoping to be given the all clear for soft foods. Getting pretty hungry over here! In fact, I created a new word to refer to my hungry--"hangry." Hangry is a cross between hungry and angry, and it aptly describes my current state!
Does anyone else expect some lasting dietary changes from this? For one thing, I am pretty certain I will be going back to being a vegetarian (well, fish only vegetarian) after this is done. I did not eat meat for years, and not eating any for the past month, I have realized that it is one thing I don't miss at all. The other thing is that I can really tell how much my stomach and, subsequently, my appetite have shrunk. I honestly feel "full" if I eat half a can of thin soup.
Bill - the portion control thing is definitively a plus. Hard to "pig out" when every bite is so damn hard to get in! Then again the real test for me will be next time I work an overnight. If around 3am I can resist the bag of doritos, success!
As far as teeth sensitivity - I have some of that too on my lower teeth, I think it has to do with 2 things - one is that the nerve still doesn't really know what it should be doing and gives off weird sensations (that's what my surgeon said), and also I know I was starting to get some gingivitis from not being able to brush properly. This week I'm finally able to get in there better and even was given the ok to floss (ahhhh joy!) and it's already getting better.
Chicago - I talked to my surgeon about the dull pain in my jaw. He thought it was probably from him pulling on a running suture on that side at my appointment last week and causing some soft tissue inflammation. I also think my bone sometimes hurt while healing (kinda like growing pains), but overall it has mostly resolved
On a note back on my insurance. Apparently when the anesthesia company submitted the claim they didn't put the proper code for place of service which may be why it showed as out of network. My insurance company, being so helpful, sent me an email saying to contact the anesthesia company to ask them to resubmit (cause that's too hard for them to do). Didn't give me a number either, so I looked through their directory and the number listed was the hospital general number. After 5 minutes of menu navigating to talk to someone, she gave me another number. Repeat step one and that person said they don't do billing and gave me yet another number, repeat all again and finally talked to someone who will resubmit the claim. Oh joy. Now just have to see the final verdict and hope the rest of the hospital claim was submitted properly!
As far as teeth sensitivity - I have some of that too on my lower teeth, I think it has to do with 2 things - one is that the nerve still doesn't really know what it should be doing and gives off weird sensations (that's what my surgeon said), and also I know I was starting to get some gingivitis from not being able to brush properly. This week I'm finally able to get in there better and even was given the ok to floss (ahhhh joy!) and it's already getting better.
Chicago - I talked to my surgeon about the dull pain in my jaw. He thought it was probably from him pulling on a running suture on that side at my appointment last week and causing some soft tissue inflammation. I also think my bone sometimes hurt while healing (kinda like growing pains), but overall it has mostly resolved
On a note back on my insurance. Apparently when the anesthesia company submitted the claim they didn't put the proper code for place of service which may be why it showed as out of network. My insurance company, being so helpful, sent me an email saying to contact the anesthesia company to ask them to resubmit (cause that's too hard for them to do). Didn't give me a number either, so I looked through their directory and the number listed was the hospital general number. After 5 minutes of menu navigating to talk to someone, she gave me another number. Repeat step one and that person said they don't do billing and gave me yet another number, repeat all again and finally talked to someone who will resubmit the claim. Oh joy. Now just have to see the final verdict and hope the rest of the hospital claim was submitted properly!
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ColoradoGirl
- Posts: 150
- Joined: Sun Jan 17, 2010 12:01 am
- Location: Santa Barbara CA
Revivalism!
How are you all doing? I'm doing well, though I increasingly find the annoyances (swelling, interior mouth torn-up-ness) annoying. At the start, it was just something I had to get through. But now I'm like--really? Does achy jaw pain really need to interrupt my day, after all this? I think maybe I've reached my cutoff point for patience with this whole thing.
Now, I only have until March 2011 to wait.... ugh.
How are you all doing? I'm doing well, though I increasingly find the annoyances (swelling, interior mouth torn-up-ness) annoying. At the start, it was just something I had to get through. But now I'm like--really? Does achy jaw pain really need to interrupt my day, after all this? I think maybe I've reached my cutoff point for patience with this whole thing.
Now, I only have until March 2011 to wait.... ugh.
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Broadway Bill
- Posts: 103
- Joined: Tue Sep 07, 2010 4:17 pm
CG, I concur. I'm nowhere near to running out of steam yet, but the aching and the torn up mouth are wearing thin. Honestly though, I'm still so amazed by feeling a proper alignment in my bite that I find it difficult to dwell on the less-fun aspects.
I've still got a lot of numbness on my chin and lower lip, but I think I'm feeling some of it come back. The odd pains that come along with nerve growth are a hassle and uncomfortable, but I can manage.
I haven't even really seen my ortho since surgery, since he wanted me to be able to open a bit more before he started working again. I go see him next week, and I hope to get a time line for getting three braces off, but I'm expecting another year or so of braces, so I'm not really stressing about it either way.
Hope the rest of my October people are doing well! Check in!
I've still got a lot of numbness on my chin and lower lip, but I think I'm feeling some of it come back. The odd pains that come along with nerve growth are a hassle and uncomfortable, but I can manage.
I haven't even really seen my ortho since surgery, since he wanted me to be able to open a bit more before he started working again. I go see him next week, and I hope to get a time line for getting three braces off, but I'm expecting another year or so of braces, so I'm not really stressing about it either way.
Hope the rest of my October people are doing well! Check in!