Orthodontic jaw surgery extra payment to surgeon?

Starblue

Hi guys,
I recently got braces and was told I would also need jaw surgery to align my bite. The orthodontist works exclusively with one surgeon and he referred me to him for a consult. The surgeon said that even though my health insurance covers the op, I would have to give him an additional payment of two grand. I agreed to go ahead with it as I thought it was standard practice. I have now found out that a friend of mine got it done in a different county and didn't have to pay anything. I am raging :mad: Has anyone gotten this done or know anyone who did? Surely this can't be right?! Thanks a mill, Starblue

kkth0360

Ask for clarification as to exactly what the €2000 is for - is it that the hospital the surgeon operates in is not covered by the health insurer? Or that the fee paid by the insurer to the surgeon does not fully cover the surgical fee?

Don't be afraid to ask the orthodontist for a referral to another surgeon for a second opinion if you're not happy with the one he usually works with. You're the patient - you get to choose who does your surgery.

Starblue

No the operation is totally covered, he said it's to cover consultation before and after and started mumbling. Consultation is 200 quid so that still leaves €1600 to be explained. I had a consultation with a different ortho before one I went with and he also mentioned that surgeon would ask for extra money so it's obviously something that goes on in Dublin. Just seems like pure greed to me.
Ortho isn't particularly friendly and did stress at start that he only works with this guy. I'm paying €5,500 for braces though so I suppose I should be able to call the shots a bit. Kinda don't want to upset the guy who'll be tightening my braces for the next year and a half tho...:(

btkm8unsl0w5r4

If you have VHI Quinn Aviva etc...your surgery is covered. There are two types of oral surgeons and Maxilliofacial surgeons part participating and fully participating surgeons with the insurers.

Part Participating surgeons get paid less by VHI etc. for each procedure and are allowed to top up the fee.

Fully participating surgeons get paid more by the VHI etc but ARE NOT allowed to add top up to patients except for the initial consultation.

Find out if the surgeon is fully participating, if they are not then switch to one that is, if the surgeon is fully participating they are not allowed to top you up. Contact the VHI or whoever and ask.

I think your requests are more than reasonable,

Starblue

Thanks a mill for that. Will check out tomorrow.:)

Starblue

Oooh just thought there, had wisdom teeth removed by same surgeon and was fully covered by insurance. Would that suggest he was fully participating? Also, could ortho refuse to refer me to somebody else? Thanks

Starblue

Hi, Fitzgeme if you're about, I rang Aviva and the surgeon is fully participating. Is it just an ethical thing that he's not allowed to charge or is it not allowed at all? I am stunned quite frankly that someone would try and take advantage of a patient who is facing into such a serious operation like this. I really appreciate your help, thanks.

Squiggle

Brecken Rotten Surf wrote: »

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Fully participating surgeons get paid more by the VHI etc but ARE NOT allowed to add top up to patients except for the initial consultation.

This was our recent experience. Our young lad had a procedure done on an impacted incisor tooth by a fully participating Maxillofacial surgeon and that's all we paid - €150 for the original consultation and Quinn paid the surgeon, anaesthetist and hospital directly after the operation.

day dreamer

Hi there


The orthodontist may not want to refer you elsewhere but if you ask i cannot see them having a problem referring you elsewhere unless there is no alternative.

You are the patient and should be able to choose what surgeon you see, you are paying afterall. However, there are not too many surgeons out there doing that kind of work so you may have to stick with the one you have.

There is a very large lab bill for making the splints used in the surgery, this is usually paid by the surgeon and not covered by the private insurance. The additonal fee may be for that

Starblue

Ah ok, that makes sense, thanks day dreamer. Spoke to secretary of surgeon who did op for colleague and they said referral from ortho will suffice so fingers crossed will all work out.