Insurance Orthognathic Surgery

[Aisling]

Hello,

I'm in the process of having Orthognathic surgery for sleep apnea. My insurance has not approved it and I need to send an appeal. I need to talk to the surgeon tomorrow. Has anyone had to put in appeals? Insurance is Blue shield of CA.

I have a retrognathic mandible (weak chin) and this is what is causing my airways to be to small. I also have problems swallowing air when I sleep and eat. This mean I belch all the time. I had braces when I was a teenager and the orthodontist was trying to correct my teeth when it should have been my jaws. When I went to an ENT he recommended the sleep study and then recommend an orthognathic surgeon. He did not say that I should have a CPAP or have a mouth piece.

Any help would be appreciated. I can give more info. if needed. This whole process is a bit daunting.

[smylex]

The ENT should be able to write something up regarding the reasons why your surgery is necessary, as should an oral maxillofacial surgeon. Most medical insurance companies will not take a referral from a general dentist or orthodontist.

You can also find more info at this link:

http://www.bracesreview.com/forums/o...-question.html

and here:

SURG.00049 Mandibular/Maxillary (Orthognathic) Surgery

Anthem is the company that runs Blue Cross/Blue Shield.