In my last post, I shared that it was finally confirmed that I was in-network. I got a call on Monday saying that the hospital called the surgeon's office and told them that I am out of network. Why they keep changing their answer? I have no idea. I am two weeks pre-op and have no clue how much this whole deal is going to cost and if I am in or out of network. I started this insurance process back in March and it still is not figured out. Needless to say I am stressed out and beyond frustrated. Apparently 4 months is not enough time to get this all sorted out.
My fear right now is that I have to schedule the surgery with another hospital and I have to post-pone the surgery date until December, which is when I have my next break in school. To those of you reading this, if you can, give this as much time as humanly possible to sort out. I probably should have done this two months sooner, but I had no idea it would be this complicated. I have been calling three different people everyday this week twice a day and leaving messages. So far no one has returned any of my calls. Hopefully that means they are trying to figure it out too. I am 95% sure I am in-network because I have an extended PPO plan that covers me when I am out of network with my primary insurer. Hopefully this gets sorted out soon. I was supposed to have all my quotes and everything pegged down this week, but it will have to happen next week... I hope!
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Being a healthy 23-year-old woman, I have fortunately not needed any sort of major surgery since I was a child. Therefore, this is my first major operation where I am on my own dealing with insurance and its coordination with the hospital and the surgeon's office. I made a mistake and want to share in hopes of helping save one of my readers some grief in the future:
It is YOUR responsibility to make sure your insurance is accepted by the hospital and surgeon's office. Do not assume their insurance teams will do it for you. Always double check and make sure this has been confirmed. Thankfully, this was figured out early to where it was not an issue for me, but it could have a huge issue. If your insurance card is like mine, there are about six different numbers and six different companies listed to contact. I have a primary health provider through my dad's insurance in Illinois and Missouri. If I am outside of those states (I am in Tennessee) then I am out of network with my primary health provider. BUT there is a different provider available to cover me in network if I am outside of Illinois and Missouri. I was receiving two different answers: "These facilities are in network." and "These facilities are not in network." If I am in network, I pay 20% of the total costs... Out of network and I pay 50%. That is a HUGE difference. So I went into a state of panic because this surgery is in three weeks and I have no clue how I am going to pay for it if it is out of network. I was assuming that the homework had been done and it was confirmed I was in network. After spending all day on the phone with several numbers on my insurance card and people from each the hospital and surgeon's office, I was finally able to 100% confirm that everyone involved is in network! I was so relieved and am so grateful to have talked to such polite and kind women. Seriously, it makes this complicated process more bearable. Also, my surgeon said his fees should not be the $8,076 quote I had receive. That was more of a quote for having TWO jaws done. So, he is having someone re-crunch the numbers and I was told that the quotes will definitely go down! So, I received a lot of good news after having a day of panic. I had been trying to get the hospital to return my calls and answer my questions for well over a month. So, I physically went down there and found the people who I needed to talk to. I was able to give the hospital a copy of my insurance card, which really helped the process go along. For some reason I assumed the surgeon's office would have faxed that over, but I was mistaken. These are faulty assumptions I have made and I hope that it saves some of you the stress and panic I experienced last week! Today was my pre-op appointment for my surgery at the surgeon's office. Since so much happened during this appointment, I will just break it down into the different procedures that were done. (In order of occurrence).
I-CAT This was pretty cool actually and, I'm sure, a very expensive test. I sat in a chair with my head against a soft support and was directed to put my chin on a holder. The technician then secured my head with a strap across my forehead to minimize movement. I was directed to keep my feet flat on the floor, relax my jaw, close my eyes, to take a deep breath, and swallow while the machine circled my head for 20 seconds. The image produced was a 3-D image of my teeth and jaw. My surgeon said the I-CAT is an amazing tool for precision and minimizing major complications. Especially permanent numbing. The scan shows exactly where my nerve is so that the surgeon can stay as far away from it as he needs to, which minimizes the chances of cutting or severing this nerve. Bones heal a lot faster than nerve tissue, so this is why it can take awhile for the feeling to come back. This scan will also be used to conduct a virtual surgery on the computer so that the surgeon knows what he will do before he gets into the operating room. Photos Not too many photos were taken. Which I was thankful for be the angles are no where near flattering. I stood in front a blue background and three photos were taken: (1) A front photo with my jaw relaxed, (2) A profile photo with my jaw relaxed, and (3) a front photo of my regular smile. I was then given two plastic devices to put in my lips to pull them out so that the woman could get a clear photo of my teeth (these were used at the orthodontist when they were taking photos during the consultation). The photos that were taken were side photos of both sides with my jaw relaxed. Then they inserted a mirror in my mouth in order to get a full photo of my top and bottom arches. Impression Molds This was by far the worst part of the appointment for me. The assistant put wax (just like the orthodontist gives) along all of my brackets and wires. The top and bottom molds were two different types of awful. For the bottom, it was not uncomfortable at all I I just waited the two minutes for the mold to harden. When the tech pulled it out, she had to work it back and forth to loosen the grip, which was rather painful. It felt like my bottom front teeth were being pulled out, which made me panic a little. Then the mold for the top teeth were mixed and put into my mouth. Remember what I said in a past blog post about anxiety related not being able to breath? Yeah... The goo filled my entire mouth and felt as if it was sliding down my throat. I told the tech how much the top mold usually bothers me so she would know. She did a great job reminding me that it is not sliding down my throat, breath through my nose, and wiggle my feet to keep my mind off it. This actually worked and I was able to block out the whole feeling of choking. The tech was asking my husband questions during this time so I focused on their talking. Distraction was key to get me through those two long minutes. It thankfully wasn't painful to get the top mold out and didn't take as long. Splint Imprint The surgeon came in and took a warm and malleable piece of wax that was thin and shaped like a U and explained that this is the mold that will be sent off for my splint. I was instructed to relax my jaw and bite my teeth hard into the mold. That was the quickest and easiest part of this appointment. Prescriptions The surgeon sat down and told me all about swelling, the procedure, risks, benefits, and the prescriptions. I will have 5 medications: (1) anti-nausea, (2) antibiotics, (3) a mouth rise that kills all bacteria, even the good, and that is not to be used for more than one week because awkward fungal growth will happen, (4) a narcotic pain reliever, and (5) a non-narcotic pain reliever. I told my surgeon how I don't want to take a narcotic anymore than I have too (they are very addictive and make me sick), so this is what he told me to do: Take the anti-nausea. 10 minutes later, take the narcotic, 2 hours later take a liquid Ibuprofen (non-narcotic), 2 hours later begin the process all over again as needed. Post-Op Kit The tech then gave me a baggie full of all sorts of fun stuff. There are two food squeeze baggies that are reusable. One has a small straw for liquids and the other has a larger straw for soups and other thicker blended foods. I also got a fancy "jaw-bra" with gel packs that can be heated or frozen for after the operation. I am instructed to keep ice on for 2 days and then switch to heat. There is also an after care sheet, which I will post under the "Bill" tab. Splint The surgeon said that it is rare that he keeps the splint in for lower jaw surgery patients. It will be used during the surgery to make sure my jaw is where it needs to be and will be removed before I wake up. I will be tightly banded shut and each week I will be loosened a little more. By week 3, I may be able to fit a spoon in my mouth. I was shocked about possibly not having a splint and the recovery doesn't sound as bad as I originally thought. Exactly one month from today is my lower jaw surgery to correct my overbite. My diet will be significantly different for the first month and I will need to make adjustments in my day-to-day life for a short period of time. So, how am I preparing for something that I am not sure what exactly to expect? I have broken that question into the following categories: Food, Mentally, Financially. Food I have bought enough Ensures, V8 Juices, and soups to last me 2 weeks. Why not more? Because I am hopeful that I will be able to eat some soft (no chew) foods after week one. I would rather buy the liquid food as I need it instead of buying four weeks worth and not needing it. Soft foods I plan to eat for 2-4 weeks: Potatoes, pasta, rice, cheese cake, pudding, boiled vegetables, fish, fried chicken (the meat not the skin), and hamburger dishes. I said I bought Ensures, but I really bought the off brand at Wal-Mart. For the same price as the name brand, I get six drinks instead of four. I also sampled the three flavors (chocolate, strawberry, vanilla) to make sure I like them before buying too many of one and here is my personal ranking: 1-Chocolate. 2-Strawberry. 3-Vanilla. I also plan to buy a gallon jug of chocolate milk and vitamin d milk as well. A tip I got from someone who went through upper jaw surgery said that she bought "baby pasta" (Ditalini Pasta) that was small enough to be sucked through a straw. So, I will definitely be giving that a try. Mentally I went through denial by telling myself that such a procedure is unnecessary and not worth the pain and inconvenience. I honestly became angry about the fact that I needed to have such a surgery when everyone else around me seemed to have "perfect jaws." It seemed like, at the time, that this is was unfair and it would of course happen to me. Thankfully, this only lasted a few days and was probably due to the fact that I was in shock about the news. I dealt with a lot of fear for quite awhile. Most of this fear is caused by the unknown. Sure, I can read other people's blogs and watch videos, but what is going to be my experience? So, what am I doing to mentally prepare? I keep reminding myself over and over of changes I will have to make during recovery. When I lay down for bed (I hate sleeping on my back), I remind myself that for two weeks I will have to sleep on my back propped up. When I am eating my favorited foods (fried chicken, bacon, sandwiches) that I will have to go a period of time without not only these foods, but foods I cannot chew and will have to drink. As I talk and laugh I remind myself that there will be a period of time I won't be able to do those things easily. BUT! I also remind myself that it is only temporary and will be over before I know it. Financially I'm in graduate school with loans from undergrad. This sort of surgery is the last thing that I can afford right now. I am banking on my insurance to pull through for me and not knowing what my hospital bill will be yet or how much will officially be covered is causing me a lot of stress. Once surgery is over, I will get either a bill or refund check from my surgeon. I will get who knows how many bills from the hospital. These bills are stressing me out and they aren't even here yet! So, what am I doing about money woes? I have saved enough over the past year and a half to cover what I think will cover all the bills after insurance. This is something I don't have control over and I am just having faith that it will come together and work out in the end. Today was my second to last appointment with my orthodontist until surgery. It was pretty quick and I was in and out in about 20 minutes. I asked him what all there is left to do with my teeth and the orthodontist said to make my teeth fit together after the surgery and widen my top arch to make my smile more full. There is no way to know how long I will have braces once the surgery is done because the orthodontist does not know where the surgeon is going to set my jaw. Therefore, the orthodontist can't predict how much my teeth will need shuffled around. On July 23rd, I have my final orthodontist appointment before surgery to get the posts put on for surgery. They are tiny compared to the ones I have seen others have. I will post pictures of this after the appointment and will post some before photos as well before the surgery. July 2nd is when I go in for my pre-op appointment. I'm sureI will have a lot to report on after that appointment, so I will be sure to post after that. I thought I would discuss some of my fears about having surgery on my jaw. Anxiety is normal before an operation and by sharing some of my fears, I hope to help you realize you aren't alone in your fears. In general, I would say I have a minor case of claustrophobia. I say minor because it does not interfere with my day-to-day life. But, I do experience anxiety when I am in a small space and my ability to breathe is compromised. This leads me to my biggest fear involved in this operation: my ability to breathe with my mouth banded shut. Another fear stems off of this one. From past operations, I know that anesthesia does not make me nauseous, but the pain killers do. Every operation I have had I experience at least one day of vomiting off and on. While vomiting doesn't bother me, I fear not being able to while my mouth is banded shut. This is not so much a fear, as a concern. But I am a bit afraid of while I am using those syringe things to feed myself, that I will accidentally pierce through or tear the incision site. How awful would that be? And be too numb to even notice... Why am I telling you all my fears? Each person will have his or her own set of fears and, once this is all said and done, I would like to compare the fears I had to the actual experience. Things typically aren't as bad as you initially think they will be. Just a couple of new things to report. The first is that I have my pre-op appointment on July 2nd at the surgeon's office. They will do some x-rays, measurements, and take impressions for my splint. After two weeks of phone tag with the surgeon's office, everything is finally in order. My payment in due on July 11th, so I will probably just pay it when I go in for my pre-op appointment. Now I am playing phone tag with the actual hospital. Everything is set on that end as well, but I still need a price estimate. I was told there will multiple different bills, including: hospital, surgeon, anesthesiologist, and lab fees. Once I have all these compiled, I will be sure to let you all know what to expect. Expect to play phone tag for awhile because you are busy and the people you are trying to coordinate with are as well. Try to leave yourself at least two weeks to get everything lined up. You will be a lot less stressed... I promise! The big day is...... JULY 26, 2014! Having a date makes this whole thing seem real and I can't believe it is happening! Just a bit more than two months away! I was unaware that it was even possible to get a date on the weekend, but I am thankful for it! My husband will have that day off and will hopefully be able to take the following week off with me. We are still trying to figure all that out. This will give me a little over 4 weeks to heal before I have to start my fall semester. Which should be plenty of time. The splint should also be out by the time I start classes as well, which is something I was worried about. I will need to talk to my professors about missing class and taking my finals for the summer semester early. The woman who does the scheduling at the surgeon's office is going to be calling me sometime either this week or next, so I will make another post if there is anything to update on. Also, I have an orthodontist appointment 4 weeks from today, which will be my last regular appointment before surgery. After that appointment, I will have one more before surgery to get the surgical wires and hooks put on. So ready to be in on the other side of surgery! ☺ I love structure and I also appreciate a nice list. Therefore, I have made a list that includes the phases of my journey and thought you may like to know the process. For the most part, this is a list of "to-do's" that many of you may need to do yourself and some of these things I was not aware needed to be done in order to get braces put on. Which, as a result, made it take longer than anticipated to have the braces put on. Phase One: Pre-Orthodontic Dental Care
Phase Two: Pre-Surgery Orthodontics
Phase Three: Surgery
Phase Four: Post-Surgery Orthodontics
Phase Five: Whitening
When I first got braces on, it felt weird. I could swore my lips were sticking WAY out and that I would have to force my lips around my braces to keep my mouth closed. All this was in my head, thank goodness. The orthodontist assistant working with me reassured me that my lips were not sticking out and that when the braces come off, it will feel as if my lips are too flat. As soon as I left with my new and shiny braces, I went to KFC to get some beautiful fried chicken and the best mashed potatoes. It felt very strange eating with braces on. It was as if I was chewing with someone else's mouth. It didn't help that the orthodontist put a material he called a "build-up" on my bottom molars to keep my teeth from closing down on the brackets. All and all, it was a weird feeling. I'm not going to lie... the pain was excruciating and I consider myself to have an above average pain threshold. The pain began about 4 hours after the braces were put on and peaked at day 3. Those three days, I barely slept because it felt as if my entire mouth was pulsating with pain. It hurt to eat even soft foods such as pasta and boiled potatoes. I was worried that this is what I would be enduring over the next two years. On top of all that, I had several canker sores in my mouth that hurt every time I moved my mouth. I used this product every 30 minutes to numb the pain and provide some relief. Pain after first getting braces: 9/10 Thankfully, the pain began to decline after 3 days and completely disappeared on day 5. It felt like a miracle! I was able to eat completely normal again and there was no pain when chewing. After day 5, it was a matter of getting used to the braces being there. After one month, it felt as if the braces were not there at all. I also only had canker sores during the first month and once in a while I will get only one as the brackets shift to a location where the inside of my mouth is not used to it. This has happened only a couple times thankfully. My teeth moved fast! (I will post pictures at some point). I had a severe overjet and my front teeth flared out a lot. I had the braces put on in March and by the end of June, all my front teeth came back significantly and all gaps were closed! Right now, the orthodontist is widening and leveling my lower and upper arch so that my back teeth will touch. The left side of my top teeth are up higher than the other, which makes my mouth look lopsided. It is amazing how much your teeth determine the support for your lips. The main foods I avoid are chewy ones, such as Starbursts, Skittles, Jolly Ranchers, gums, and caramels. There are a lot of foods to avoid, but these are the main ones that I personally had to give up. I was told it was okay to eat popcorn as long as I ate the popcorn on the top and not the bottom. I have eaten plenty of popcorn with no issues. I have adjustments and wire changes every 8 weeks. Afterword, the pain is no were near as severe as when I first got the braces on. There is only pain when my teeth touch or when I bite/chew. Therefore, the first two days I eat pastas and make soups. After two days, I can begin some chewing again and after 5 days there is no pain. Pain after braces adjustments: 3/10 I have heard people say that dental wax does not help, but those people are lying. If you have a canker sore, it is important to use wax over the the nearby brackets so the sore can heal. Once I put wax on, the sore was healed in a couple of days. If I did not put wax on, the sore would stay there for a week or more.
Each person will have a unique problem area where they may need to use wax throughout the entire process. For me, it is my top four teeth. The brackets irritate and rub my upper lip and it can get pretty sore and tender. Right now, I put wax on before bed every other week. The more my teeth come back, the less often I need to use the wax. So be sure to always keep wax around! Hope this helps! Feel free to ask questions about this post or topics I may not have covered ☺ The entire procedure will take place on the inside of the mouth. Therefore, there will not be any scars on the face. Basically, he or she will make an incision on each side of the mouth where the skin meets the tooth bearing portion of the jaw. From here, the jaw will be cut. Then brought forward the desired millimeters and secured into place with plates and screws. The surgeon will then sew up the incision site, put in the splint, and secure your jaws with bands on the surgical hooks that were put on your braces a week or two before surgery by your orthodontist. If you are brave and have a strong stomach (I don't...), you can go to YouTube and watch an actual procedure being done. But only if you are into that sort of thing... Click here to see an animation (no blood or gore!) of the surgery to give you an idea of what the surgeon will do. If you have any additional questions, please feel free to leave them in the comments below! Over the past three months, I have been calling back and forth between the insurance company and my surgeon's office. My insurance states specifically that jaw surgery and the splint are covered. I am responsible for paying for 20% of the cost once my $300 deductible is met and the insurance company will pay the other 80%. I won't know the official costs until after the surgery and my insurance is billed. There will be two bills. The first is the surgeon bill, which is estimated to be $8,076 and I am responsible for $1,855 of this total, which includes my deductible. I am currently playing phone tag with the surgeon's office in order to schedule the date and find out what the cost from the hospital will be. The receptionist told me that the surgery will be about 3.5 hours and will be an outpatient procedure, meaning I will go home the same day. I will be wearing the splint for four weeks and after that, I can begin to ease my way into my normal diet. I have only gone to the surgeon's office once for my consultation, which only took 15 minutes. He stuck his fingers in my mouth and examined how my jaws relate to one another. Thankfully, he said my upper jaw is good and just the lower jaw will need to be brought forward and secured with plates and screws. I won't go back to the surgeon until one week pre-op. During this appointment, they will do molds, x-rays, and discuss everything from risks to benefits involved with the surgery. I will also go to the orthodontist about 1-2 weeks pre-op in order to get the wonderful surgical hooks put on, which I've heard cut up the insides of your mouth worse than braces did when you first get them on. I am preparing for surgery by picking up a couple things each time I go to the store in order to avoid a HUGE grocery bill right before the surgery. My husband makes fun of me because we will be spending the same amount of money buying it all at once as we would by purchasing things here and there. Small purchases make me feel as if I'm not spending as much, which makes me feel better about the situation ☺ |
WelcomeThis blog documents my journey through lower jaw surgery in hope of providing help and insight involving the experience. Archives
October 2015
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1 Year Post-Op 9 Months Post-Op 6 Months Post-Op Paying for Jaw Surgery 5 Months Post-Op Retainers Braces Off 4 Months Post-Op Fear vs. Reality 3 Months Post-Op 12 Weeks Day 81- Ortho. Apt. 2 11 Weeks 10 Weeks 9 Weeks Day 59: Surgeon Apt. 4 8 Weeks 7 Weeks 6 Weeks 1 Month Post-Op Day 27: Ortho. Apt. 1 Day 25: Surgeon Apt. 3 3 Weeks Day 17 Day 12: Surgeon Apt. 2 Day 10 Day 9 Day 8 Day 7 Day 6: Surgeon Apt. 1 Day 5 Day 4 Day 3 Day 2 Surgery Day (Day 1) Pretesting Appointment Surgical Hooks 1 Week Pre-Op Insurance is Complicated Caution with Insurance Pre-Op Appointment Planning and Preparing Orthodontist Apt. My Fears Pre-Op Date Surgery Date Phases of My Journey Life with Braces The Operation 3 Months Pre-Op |