Yeah, this is late. Whoop-dee-fuckin' doo.
Woke up Tuesday having forgotten to turn off my alarm. That was probably a good thing with the time change, much as I hate it. Played around with the ACID Music Studio Pro program, showered and went off to Disneyland before it got too hot and the crowds got ridiculous.
Left the park and headed over to the surgeon's office. The route 29, however, was running late - so late that there were 3 buses coming my way when I transferred off the 70! (Way to cut service, OCTA.) I had the feeling that this might happen, so I had contacted the office prior to let them know I might be a few minutes late, but that I was still coming.
I get to the office and walk into the building after finally locating the front door that's adjacent to the parking lot. Walk through the glass doors into a lobby leading to three offices. Looking from right to left, I find Dr. Levin's office to my left side. I went in, advised them I had an appointment. They gave me my health questionnaire and ask for my license and medical insurance card. Fill out my paperwork and wait to be seen.
I was led into an operatory where Dr. Levin introduced himself. We immediately started discussing my options for surgery. As I thought, he stated he would most likely be performing the bimaxillary osteotomy to correct my underbite. He stated, however, that he wasn't going to notify my medical group at this time to get approval of the surgery as it was still too early and that I wasn't in braces yet. I advised him of the problems that I had been facing regarding the insurance company and Dr. Levin advised me that this type of condition is covered under my insurance policy.
I went back into the lobby and got a card for Dr. Patrice Punim to get an orthodontic consultation, then realized that her office was right next door and thought, "Fuck it, I'm right here - why use the cellphone minutes?" I went in and spoke to the lady at the desk who scheduled me for Tuesday of next week. I forgot to ask if they were going to need x-rays. That's not a worry, though. I can just contact the x-ray lab to e-mail them over.
Even after all of this, I still have to wonder if I'm going to be having trouble with BCBS in trying to get this approved. I think I'm going to have to contact the medical group myself and ask them, though I may be worried more than necessary.
I found out later that the insurance company and the medical group will only authorize treatment within 60 days of any actual procedure. Upon speaking with the medical group after my appointment, I found that since I was already referred to the OMS by my physician, I should be approved by them for the procedure without any trouble. (Author)
Well, see you back here next week for another update where I hopefully will share the treatment options given by the orthodontist.
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Good, you've taken the first step.
ReplyDeleteI have CIGNA, and I made sure that they would approve the surgery before they put me in braces. If they hadn't and I had waited, I would be in braces forever until I could find a way to pay for it.
If you can, get another surgical consult. Get a referral through the ortho you ultimately choose. It is imperative that your ortho and surgeon work well together.
See, this is my fear - that the surgery won't get approved and I'd be stuck with a messed up bite (even more so with the braces to get the whole thing started) because someone couldn't/wouldnt' do the paperwork or steps necessary to obtain prior approval for the whole thing after I got the braces on to get ready for the surgery in the first place because I don't have the funds or credit to get a loan to cover this.
ReplyDeleteAlso, getting another consult would require going out of my medical group as this is the only OMS in the group. Time to start making phone calls.
Gotta love bureaucracies - both the medical group and my insurance companies are telling me to ask the other one. *rolls eyes*
ReplyDeleteThe medical group did say, however, that I've already shown documentation that I need this surgery approved, so I shouldn't have too much of a problem (I hope).
Neither of those groups are going to have an eye on your wallet.
ReplyDeleteGet the medical group to send paperwork for preapproval to your insurance company. They may whine, but you'll have piece of mind starting this process if you know they've approved it.