Rachel Nabors ([info]crowhen) wrote,
@ 2009-02-02 12:30:00
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Entry tags:teeth

The Insurance Company announces their position on my jaw surgery!
Just got a call from the surgery regarding their little chat with my insurance provider. Wow, insurance companies can be so inept. My providers said they will review my case after my surgery and hospital stay to determine if it is something they cover.

...

I really dislike the way that sounds, especially when a hospital stay tacks on an additional, what was it again? $5,000? More?

Called my orthodontist back and left a message stating the above and asking if he would check if the new Durham clinic has insurance options. If they don't, I will be faced with a real game show-worthy question:

Do I go to the surgery and risk paying twice as much on the chance that the insurance company will pay for some/all of it? Or do I go with the less expensive option I will have to pay for completely out of pocket?

Because the rumored clinic would be local and I have a job (which I start tomorrow!) that pays enough that I could actually save some money, I personally lean toward the out-patient clinic instead of the surgery.

I think it's ridiculous that have spent months fumbling through in insurance agents, paperwork and consultations to get down to this simple either/or formula. Damn you, bureaucracy!


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[info]kayjkay
2009-02-02 05:42 pm UTC (link)
Have you asked how much the surgery costs without insurance? Asking because that was our problem, we had insurance, they didn't/wouldn't cover the MRI I had last month, but if we paid out of pocket, it was $951 versus three thousand.

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[info]crowhen
2009-02-02 05:58 pm UTC (link)
I'm pretty sure there is no difference.

(Reply to this) (Parent)

[info]thedalaimama
2009-02-02 05:54 pm UTC (link)
Go for it. Plan on one of the out-patient options. Surely we can all pull together and make it happen if the insurance refuses to help. Yes We Can!

(Reply to this) (Thread)

[info]crowhen
2009-02-02 05:59 pm UTC (link)
I'm very positive with the $9k in donations and smart saving, possibly a small loan, that this can be done with or without the insurance company's cooperation. I really couldn't do it without those donations, though, as even with work, the cost of all this together is immense. So, I'm so happy people have been this kind to me.

(Reply to this) (Parent)

[info]smurasaki
2009-02-02 07:16 pm UTC (link)
A pox on insurance bureaucracy.

*offers hugs*

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[info]crowhen
2009-02-02 07:32 pm UTC (link)
*hugs*

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[info]jinnayah
2009-02-02 07:30 pm UTC (link)
I feel your pain. Insurance companies are stupid. When I had my gum graft, they'd only cover it if there were x-rays taken. It's a soft tissue procedure.

I hope you can get it all sorted out one way or another.

(Reply to this) (Thread)

[info]crowhen
2009-02-02 07:31 pm UTC (link)
Thanks :) I will give it my all!

(Reply to this) (Parent)

[info]shutenchouten
2009-02-02 07:31 pm UTC (link)
Jeez. I'm not sure what to tell you as far as your situation, but I will be glad to support you and anything you decide!

Good Luck!

(Reply to this)


[info]mshepley
2009-02-02 07:56 pm UTC (link)
*snort* Most of the cost of Insurance goes to the Administrative costs. That is, paperwork and bureaucracy. If they could trim the process down and streamline things, insurance would be a lot more affordable.

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[info]rae_beta
2009-02-02 09:03 pm UTC (link)
For what it's worth, I've had insurance companies surprise the hell out of me by taking this stance and then actually paying for whatever it was (and one of the times, it was, in fact, outpatient jaw surgery to correct a bone deformity). I know I got way lucky (and had a surgeon who was willing to call the insurance company and--according to him, at least--literally yell at them until they agreed to cover it), but expecting the worst doesn't have to rule out hoping for the best.



That said, FUCK THOSE INSURANCE JERKS.

(Reply to this)


[info]kimonos_house
2009-02-02 10:58 pm UTC (link)
*nods* Standard insurance procedure. They did the same thing to me a couple years ago, and I backed off of getting the surgery because I had no way of knowing whether it would be covered.

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[info]empress_tigress
2009-02-02 11:28 pm UTC (link)
Do you remember that scene from The Incredibles? When Bob's boss constantly yelled at him because all his clients were getting pay-outs? That's not too far from reality.

This is par for the course for insurance. Many insurance companies do this ON PURPOSE because they know that if they stall long enough that you'll eventually say "screw it" and pay for it out of pocket or go with a cheaper option. Insurance companies aren't there to help you, they are there to make money, which they aren't gonna do if they pay for expensive medical procedures.

Since the insurance is dicking you around, my advice is to lawyer up. Find an attorney that specializes in insurance cases, sign a HIPPA waiver to give him access to your medical records and sic him/her on the company. Usually, all it takes is an aggressively worded letter from someone with PLLC at the end of his/her name to make an insurance company suddenly very eager to cooperate with you.

(Reply to this)


[info]jasonfranks
2009-02-03 11:52 am UTC (link)

I wish I could've typed the Turrets rant about American insurance companies that I just sprayed across my monitors, but even if I could keep up, I think it might have broken the internet.

-- JF

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