Friday, October 10, 2008

Plates and Screws, insurance and bills ...

I tried to take a picture of my exposed plate and screws since Kam asked! It is really hard to get the right lighting inside the mouth and the camera to get the right focus for the pictures to turn out right, so I appologize that they are not the best, but you can at least get an idea. The plate is silver, and the screws are actually a gold/bronze color. Hopefully you can make sense of it ...

The bottom two pictures probably best show the gold screws, but the first pic turned out the clearest.
I forgot to post the other day about my insurance. I was reviewing my EOB's that starting coming in (not all have come in yet), and they were processing my surgery claims as out of network! Which meant that they were only covering 70%. I hadn't planned on this, and I had verified several times before hand that my surgeon was in network. So, I called, and the rep I talked to made several phone calls, and their internal information wasn't up-to-date, so he said that all claims would be re-adjusted to in-network coverage. "Good for you for following up on this and not just letting it go!" he said. Jeeeez ... we are talking about a lot of money to just let it go! He was a very nice and helpful guy, though. With all of the bills coming in, I just wanted to verify what applied to my out of pocket max and what I actually had to pay. We got it all sorted out, and he took the time to anser all my questions.
So, when in doubt, call! Make sure you understand your plan beforehand, and go over EVERYTHING with a fine tooth comb to make sure it was processed correctly. In this case, it saved me many THOUSANDS of dollars!


Kam said...

Wow! Look at that! It is hard to take pictures inside your mouth, I tried doing the same for my incision, didn't really work like I imagined it would! :D
But I can definitely make sense of your pictures. That's really surprising how visible it is!

You know, me and my mom both think the insurance makes those "honest mistakes" on purpose. My insurance over charged us too! (And they do it ALL the TIME!) I guess they make extra profit off of the people that either don't realize they've been overcharged, or the people that don't care enough to do something about it. (The insurance does not make it easy on the customers to fix the company's own mistakes!!)

Hopefully that's the last you'll have to deal with the insurance's mistakes, but keep an eye open, you'll be surprised what the insurance tries to get away with! sneaky sneaky!

Anyway, I hope you're doing well, you are looking better and better each day!

stephanie said...

Whoa!! That is CRAZY! (The plate, not the insurance).

I believe it about the insurance - it sounds like this is a very common insurance. I know I'll be checking everything closely before and after my surgery.

Thanks for the update, Steph

ummul said...

It's a great journey!



Jen said...

are you getting feeling back in your mouth yet?


Jen said...

Thanks for you comments on my blog. They helped so much. I discussed it with my Ortho today and am also feeling better. I want that perfecr simle. I just hope that my nerves are as well protected as yours.

Scary and cool at the same time to see you plates.

You look really good with the surgery. Why did you not do it earlier?

Stephanie said...

Jen, I was told 8 years ago that I needed the surgery. I went to the orthodontist, he referred me to an OS, and we ran it through insurance, who denied the surgery. Over the following years, my problems with TMJ dysfunction, migraines, etc. increased. In June 2007, I went back to the ortho again, and they did a tomography which showed degeneration of my right condyle. I began to understand how serious this all was, so we ran it through the insurance again, and again it was denied. I was older and wiser, however, did my research, and we appealed, at which time it was approved. That is when I got my braces and started the process leading up to surgery.