My orthodontist and dentist feel that I need to get Othorgonathic surgery to fix my underbite. They want me to to get surgery to my upper and lower jaws. To be honest I agree with them. I cant close my mouth comfortably along with the fact that I grind my teeth at night and I am already developing minor TMJ issues. However it says this in the exlusions & limitations section of my benefits information Upper and Lower jaw bone surgery except as required for the direct treatment of accute traumatic injury or cancer Orthogonathic surgery, jaw alignment and treatment for the tempromandibular joint except atreatment of obstructive sleep apnea Services for the evaluation and treatment of tempromandibular joint syndrome (TMJ) whether the services are considered to be medical or dental in nature. Has anyone else run into this problem? Were you able to successfully appeal? if so how? By the way I'm over 19. Thanks I would like to be able to smile in pics. for a change!
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Call a very experienced oral maxillofacial surgeon. They are usually located in educational medical schools or consult a trauma hospitals....the folks that operate on gun shot wounds to the face....that is the surgeon you want doing this type of surgery....it is complicated. Call this type of surgeons private practice and ask who is in charge of billing...they usually know how different insurance cos work and how to go about getting coverage. I'd also make sure the doctor is not only a DDS (doctor of denistry), but also an MD (medical doc). Most really qualified oral maxillofacial doctors are...these guys are like artists or even more qualified than plastic surgeons.
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