How to Know for SURE my Insurance Will Pay for a Deviated Septum, Septoplasty, and Turbinate Surgery??

Question

In Jan I would like to do a rhinoplasty procedure for cosmetic reasons but I also need to fix the problems listed above as a functional portion of my nose I have problems breathing through my nose and I have sleep apnea They should pay for the function part of the surgery as well as the operating facility and anesthesia I will shop for a NEW insurance plan in January. How can I know they will pay for this B4 I BUY will giving them CPT codes help? I know they wont pay for the cosmetic part HELP

Jed H. Horowitz, MD, FACS · Answer

most companies are required to give you preauthorization..  need need the codes, cpt and icd9 and examination as well as a letter of medical necessity.

	you purchase your policy and must be your own advocate

Catherine Winslow, MD · Answer

While MOST insurance companies will pre-authorize for common nasal issues affecting breathing and quality of life, there is NEVER a guarantee attached to that. You should have enough reserve finances to account for the possibility of denial, which can happen even with a pre-authorization. However, remember that there is an appeal process with any denial. Good luck!

Ronald Schuster, MD · Answer

I agree with the others. You need to read the fine print to be sure there is not a waiting period. Also more insurance plans are requiring a certain period of time, like 3-6 months, of conservative medical treatment before they will approve the surgery. Speak to your benefite office at work for help or contact your insurance representative to also help you.

Steven Wallach, MD · Answer

You should check with your insurance company to see if you can get pre-authorization for the procedures.  I suppose like someone else wrote, prepare to pay for it all jsut in case. But you really should know ahead of time what your insurance company will cover.

Michael L. Schwartz, MD · Answer

The brutal truth is you can never be sure.  Even when a physician's office obtains preauthorization for a surgery it alwasy comes written that preauthorization is not a guarantee of payment. Health insurance companies can refuse to pay even if authorized and sometimes employ "recovery companies" to demand money back up to two years after they have paid. This reprehensible practice is only tolerated in the medical field where patients expect third parties to pay for their services and legislatures protect insurance companies.

How to Know for SURE my Insurance Will Pay for a Deviated Septum, Septoplasty, and Turbinate Surgery??

Answers (7)

Answer: Nasal surgery

Answer: Nasal surgery

Answer: Insurance coverage

Answer: Insurance coverage

Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

How to Know for SURE my Insurance Will Pay for a Deviated Septum, Septoplasty, and Turbinate Surgery??

Answers (7)

Answer: Nasal surgery

Answer: Nasal surgery

Answer: Insurance coverage

Answer: Insurance coverage

Browse related questions

Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.