Friday, February 19, 2010
Surgical Preparations
Not all insurance companies like to pay for jaw surgery. So, in order for us to get all our information together to submit to UnitedHealth, I've got some work to do. I have to visit a Speech Therapist, an ENT and Dr. Posnick also wants me to have a sleep study done, which I'm still not quite sold on. So I visited the Speech Therapist first and learned a lot! She asked me some questions that some people would think were a little strange - "Do you chew predominantly on one side?" "Do you completely chew your food before you swallow it?" Well, come to think of it, I ONLY chew on my left side and I never chew food down to a small piece. Why, you might ask? Well, chewing for me is literally a pain in the jaw. It's very difficult and a huge strain. So, the less I have to chew something, the better off I am. Luckily, I haven't choked on anything yet! :-) Back to the speech lady - I had to say the alphabet and read statements that were typed on a piece of paper. All in all, the appointment took only a short time and she sent me on my way, telling me that she would send the report to my surgeon. Next up, the ENT, who confirmed my deviated septum which will also be taken care of at the time of my jaw surgery, as it's very simple to get to and complete and hey, if they're already in there, why not?
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2 comments:
Hello Aimee,
I have been reading Graham and your blogs to mentally prepare myself for my double jaw surgery in 10 months.
I noticed you said you have united. Were you successful in getting them to cover it? My surgeon submitted a letter which got denied and frankly I don't want to pay the 25k price tag. Any advice is greatly appreciated.
Hi there. Yes, we have UHC and yes, we did get them to pay for a portion of the bill. However, the quote we got from them, the coverage they quoted, is NOT the coverage we got. So they denied your entire claim? Is your surgery medically necessary? My surgeon was very thorough - I saw an ENT doc, I saw a speech pathologist...each of them saying that I did, in fact, "need" the surgery, therefore making it a covered procedure. We did end up paying a large amount more out of pocket than anticipated and after three appeals, were still denied. :( Needless to say, UHC was not easy to deal with and I found it very difficult to even understand why they were denying what they said they would originally pay. You may want to talk with your surgeon(s) and make sure that you are given every opportunity to have the necessary pre-op evaluations so that it can be deemed medically necessary for coverage.
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