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Insurance Coverage
The cost of treatment can also be an intimidating topic for patients considering jaw surgery. Many patients ask, “What dental procedures are covered by medical insurance?” or “Is oral surgery covered under medical insurance?” While it is not true for all oral surgical procedures, orthognathic surgery is covered by your medical insurance, not your dental insurance. Navigating your medical insurance can be an overwhelming task for many patients, but rest assured you will not have to face it alone. We will take care of all insurance paperwork that your insurance company will allow us to do. There are some steps that insurance companies attempt to make difficult and require the insured to take action. When that is the case we will explain the process and steps to you and help with questions that arise. The first step we will take is to submit your case to the insurance company and explain that this is medically necessary to restore appropriate orofacial function derived from an underlying congenital or post-traumatic misalignment of the jaws. It is not a cosmetic or dental procedure as many medical insurance companies will attempt to claim to avoid paying. Next, while we are in network with many major medical insurance plans, if we are out of network with your medical insurance, we will work through a process called a “Gap Exception” in order to maximize your insurance coverage and make sure that your insurance company is paying their fair share. Finally, in the rare event where medical insurance coverage is denied or extremely poor, we can discuss a fixed rate cash option in a surgery center to make this an affordable option even when insurance coverage is not available.To Summarize How Oral Surgery is Covered Under Medical Insurance
- Submit to medical insurance and advocate for approval on your behalf
- Submit for gap exception to make insurance pay their fair share
- If insurance coverage is unattainable or unaffordable, discuss cash option for treatment
Frequently Asked Questions
Most dental procedures are not covered by medical insurance, but fortunately for our patients orthognathic surgery is often an exception. We will work with you to help get oral surgery covered by your medical insurance if possible.
After the consultation, if you are interested in pursing a combined orthodontic and surgical treatment plan we will submit all relevant information to your insurance company within several days. Unfortunately, it typically takes 6 to 8 weeks to get a response from your insurance company regarding coverage status.
Sometimes insurance plans have specific exemptions regarding orthognathic surgery and we are not able to obtain an insurance approval. While this is uncommon, it does happen and we have solutions for patients. We offer a cash rate for surgery in an outpatient center. We use the same anesthesiologist, engineer, equipment, and surgical team, but we are able to control the cost at an outpatient center so we can define the cost beforehand. The hospital will not allow us to set a fixed surgical fee, so we need to use an outpatient center when this is the case to make this treatment affordable and accessible to patients and remove unanticipated costs.
While we are in network with many major medical insurance plans, if we are out of network with your medical insurance, we will work through a process called a “Gap Exception” in order to maximize your insurance coverage and make sure that your insurance company is paying their fair share.
Unfortunately, medical insurance does not cover most dental procedures. However, orthognathic surgery is often an exception. We will work with you to help get oral surgery covered by your medical insurance if possible.
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Why Patients Choose Us
Vidya Chadaga
16:32 02 Mar 23
I recently had the pleasure of being treated by Dr. Adam, and I can't recommend him enough. I was in a critical condition and needed an oral surgeon urgently. Thankfully, Dr. Adam was able to squeeze me in for a new patient appointment at a day's notice, and I'm so grateful he did. From the moment I walked into his office, I knew I was in good hands. Dr. Adam was patient, detail-oriented, and answered all of my questions, putting me at ease despite the severity of my condition.Initially, I went to Dr. Adam for a second opinion, but after meeting him and seeing how he approached my situation with care and concern, I knew I wanted him to perform my surgery. It turned out that I had a tumor, but Dr. Adam's expertise and skill made me feel confident that I was going to be okay. Throughout the entire process, he treated me like a human being, not just a patient, and that made all the difference in the world.In the end, the surgery was a success, and I'm so thankful to Dr. Adam and his team for everything they did for me. If you're looking for an oral surgeon who truly cares about his patients and delivers outstanding results, Dr. Adam is the one for you. Thank you, Dr. Adam, for your patience, expertise, and above all, your humanity.
Bonnie Ainsworth
06:17 01 Mar 23
Dr. Adam Fagin came highly recommended by my orthodontist to correct a severe open bite as part of a treatment that I have been delaying my entire adult life. Dr. Fagin spent a significant the time reviewing my information and answering all of my questions and giving me clear insight into my diagnosis. I have never had a medical professional so clearly outline the entire treatment in such a comprehensive and transparent way. Correcting my jaw issue has been something I have been putting this off for a very long time, mostly due to a lack of understanding of what the treatment would entail. I now know exactly what will happen step by step. I'm beyond confident that Dr Fagin and his team will be able to get me through this procedure so I can one day finally be able to eat a sandwich normally.
Kelly Ernst
03:37 28 Feb 23
Look no further for your oral surgeon. Dr. Adam Fagin provided reassuring and expert care during a stressful time for me. He is very caring and detailed in explaining tooth extraction and implant placement. His surgical skills are superb, and I healed with no complication. I felt my care was in the best hands possible because Dr. Fagin is trained as both a physician and oral surgeon with so many years of training with the nation’s top surgeons - we are lucky that he came back to practice with his father here on the Peninsula. His team at the practice was friendly, efficient and easy to contact. Dr. Fagin and his team make dealing with surgical dental problems as good as it gets in my opinion!
Ashley NL
18:37 17 Feb 23
I just had a consult with Dr. Fagin for jaw surgery this week. I went in with low expectations, as a different consult with a different provider was nothing but negativity. But WOW. I loved Dr. Fagin! So kind and really takes time to explain the procedure and answer all my questions. I felt so listened to, and it was very clear to me he is passionate about his work and cares about his patients. I didn't feel like I was rushed and felt he talked with me instead of at me. I was reluctant to drive the 6 hour round trip to him, but 110% worth it. I have nothing but positive things to say about him and the office!
Angela McManus
00:48 14 Jan 23
Dr. Fagin makes having a implant an OK experience. Walks you thru the whole process. Terrific follow up and great team.
Jennie Gerlach
17:00 30 Dec 22
Dr. Adam Fagin worked with me to conduct a three-part jaw surgery to fix a crossbite and upper jaw slant. He did an excellent job from start to finish. At our initial consultation, he took the time to hear my concerns and to lay out the possible treatment options. He had a lovely handout that helped me visualize the pros and cons of the surgery and helped me remember the details as I went home to consider which path I was willing to take. As we moved forward, his team worked with my insurance and communicated with me so there were no surprises when it came to the financial side of the procedure. The consultations before and after surgery were excellent and so encouraging. Dr. Fagin was patient with my questions, encouraging and positive regarding the progress of my healing, and incredibly accommodating for my schedule. As for the surgery itself, it went great. Dr. Fagin showed me the surgery plan and communicated every bit of the procedure to me so I felt comfortable. The recovery was exactly as I expected it to be and I'm very pleased with the outcome. Overall, I had an excellent experience with Dr. Fagin and his team and I highly recommend him!
Toni Rose
12:21 17 Dec 22
Dr. Adam Fagin is THE best specialist I have ever been to. From the moment I had a consultation to the moment I got my wisdom teeth extracted it was truly a great experience. I got my wisdom teeth extracted yesterday and it was my first time ever being sedated. I was nervous about the whole procedure but it went by so quickly. His dental assistants Rondale and Taylor made me so comfortable before and after the procedure. As I got seated Rondale and his funny sense of humor gave me a blanket to keep me warm and suddenly my anxiety was slowly going away. Dr. Fagin came in and reassured me about any questions I had and I knew I was going to be in good hands by himself and his staff. After feeling nauseous during the procedure Taylor made sure I was doing okay, she gave me water, assisted me to the bathroom, and wheel-chaired me to my car.It’s only day two of recovery but my first day was painless mostly because I’m still numb. I’ll be sure to follow the post-op instructions to make the healing process fast and efficient. Thank you Dr. Fagin and staff.
Andres Godoy
20:07 10 Nov 22
I would 10/10 recommended anyone to come here for any sort of dental needs! I was extremely nervous to get my wisdom teeth removed, but Dr. Fagin and his staff were extremely kind and supportive throughout the process. As for my recovery, I was provided a care package with instructions to help reduce my pain and swelling. Dr. Fagin personally called me to follow up, after the procedure and to check in on me. I enjoyed my experience, and would recommend Dr. Fagin any day!
Linda Rolley
19:51 13 Oct 22
I was referred to Dr Adam Fagin in Jan 22 from my primary dentist for a impacted back tooth. Dr Fagin found a funny growth under my tongue. He took a biopsy.This came back as cancer. I was then referred to Dr Ryan head of oncology head,neck and throat at UCSF.It was a squamous cell tumor pushing up thru my tongue.I had major surgery in March. 6 months later my biopsies, MRI and PET/CT have all come back cancer free. I am one very lucky lady.I owe all this to Dr Fagin. If he had not taken the time and found this I don't know how long I would have gone on.He is a excellent dentist that goes above and beyond. I would recommend him to anyone for dental and more.He is kind and caring.I feel I just may owe my life to him.With the utmost respect for Dr Fagin.Linda M Rolley
Mariana Torres
16:06 17 Sep 22
I was really nervous to get my wisdom teeth removed. I did a lot of research and my dentist highly recommended Dr. Fagin. I like most people fear the dentist and personally had bad experiences in the past. I cannot be happier with my overall experience at San Mateo Oral & Maxillofacial Surgery. The staff is super friendly and helpful. They addressed all my questions and concerns before the procedure. The day of the actual procedure was a breeze and the recovery was quicker than I expected. The doctor calls you the afternoon after the procedure to answer any additional questions in regards to the recovery. The post check up a week later was also quick and easy! I would also like to add that my insurance was out of network but their administrative staff is great so the billing process is very comprehensive and they make the claim directly with your insurance. 10/10 would recommend to anyone.
Kimberly Clark
05:00 23 Jul 22
My daughter recently got her wisdom teeth pulled by Dr. Fagin and everything was great but then she started to feel some pain about 10 days post surgery. We were supposed to leave for a trip out of the country the next morning and out of an abundance of caution wanted to make sure that she didn’t have an infection. We ended up calling Dr. Fagin at 8:30 pm on a Friday night for advice and he was able to meet us at his office by 9:15. He was super caring and responsive throughout the whole process and we feel lucky to have him as a surgeon. Would highly recommend Dr. Fagin and this practice.
Irvin Ungar
22:24 21 Jul 22
dr adam fagin was absolutely terrific - professional and knowledgeable in every sense - right away I knew he was confident and competent and did not hesitate to have him work on me - really an excellent doctor - would not hesitate to highly recommend him! Irvin Ungar
Grace Mancilla
22:07 21 Jul 22
They did a great job! Super nice people. And they make it easy for you to understand at what they are looking at! Overall great people and great work!! Nice place too!🙂
Cloud Bell
01:20 12 Jul 22
Dr Adam Fagin was absolutely amazing. I was nervous about the procedure and he was so kind and patient. Once he ensured I was completely numb, he took the teeth out so quickly and efficiently I could hardly believe it! The office staff were all friendly and helpful too-I highly recommend this practice and Dr Fagin.
YL
15:42 29 Jun 22
I had an amazing experience with Dr. Adam Fagin and the staff at the clinic.I was very nervous walking in and didn’t know what to expect. Dr. Fagin explained everything to me patiently and he also listens. The entire surgery was smooth and painless. I went under full sedation and extracted all four wisdom teeth at once. He was very precise and gentle, and only cutout mini holes to do that. The staff there was very friendly, efficient, and professional as well. They gave me a blanket to keep me warm during the surgery and patiently walked me through post-surgery self-care at home. I treated it like bible and followed every step of it. it’s so helpful!Dr. Fagin is very knowledgeable and also very caring. After the surgery, he caught my potential dry socket complication early and took actions early, so it wasn’t painful at all like other people said. It also healed in 2 days.I don’t have more wisdom teeth to extract, but if I did, I would go to him again.
Shashwat Srivastava
23:52 06 Jun 22
Dr Adam Fagin was really helpful in my case where I was having a terrible toothache on a tooth on which another doctor had done a root canal and put a cap on. Due to a botched root canal 2 years ago, I was severely in pain and even had a fever due to infection and pus spreading. I went to see Dr Adam Fagin and he instantly treated me. He even made an effort to call me later in the evening to see if I was doing ok. He is skillful, knowledgeable and compassionate. Would highly recommend him.
Sarah Winkel
23:50 18 May 22
I was nervous to get my wisdom teeth pulled, so I put it off until they started to hurt. Because of that, I was relieved that the whole process was quick, from the consultation to recovery. Dr. Fagin came highly recommended to me. All pre-surgery instructions were clear, and I felt comfortable going into the appointment. The whole staff made me feel relaxed on the morning of surgery. Before I knew it, the entire procedure was over and I was on my way to recovery. Dr. Fagin made me feel very at ease and was patient to answer all questions. Overall, they turned a stressful situation into a pretty positive experience.
Serena Nash
03:53 10 May 22
I had my wisdom teeth removal with Dr. Adam Fagin. From my first consultation through follow-up appointment Dr. Fagin & his team provided excellent care, were consistently informing me about the procedure and were incredibly comforting throughout the process. For my actual wisdom teeth removal I experienced almost no pain immediately after and in the days recovering from the surgery. The procedure itself went by very quickly, and following the teams instructions led me to a very speedy recovery- by days 3 & 4 I felt back to normal already and could eat/talk no bother. Dr. Fagin's expertise and patient care made this such an easy process for me- it was great to still feel well enough to be able to work from home while I was recovering the first few days after the surgery. I also ended up never needing any of the prescription medication, I found that Advil/Tylenol & ice worked great. I had previously had a consultation with another doctor in Burlingame who was definitely less expensive than Dr. Fagin's office- however after meeting with both I was confident that I made the right decision at my consultation with Dr. Fagin and after such an easy procedure & recovery I'm even happier with my decision. Thank you guys again- cannot recommend enough!!
Aria Afjei
18:04 25 Apr 22
My experience with Dr. Fagin was great! The staff at his office were really efficient. The new patient forms were really easy and I didn’t have to wait much time until after I filled them out to get seen by the Dr. Fagin. I had to get my 2nd wisdom tooth out and was anxious that it was going be a painful long operation, but Dr. Fagin was literally an hour process and made me fewl comfortable the whole time. I felt like Dr. Fagin did an excellent job and would recommend him.
Ivan Ilinsky
21:16 22 Apr 22
I had an urgent, late-afternoon referral to Dr. Adam Fagin after my dentist had trouble extracting a wisdom tooth. His staff registered me promptly, after which the nurse took my blood pressure and some x-rays. Dr. Fagin showed me the 3D scan of my jaw, explained the situation clearly, and gave me a couple of treatment options. It had been a long day of dental work and I wanted to be done with it - I chose to get the extraction done then and there. I was prepared for another hour of yanking like I had at the dentist, but Dr. Fagin was able to expertly remove the tooth in what felt like 10 minutes, all the while checking on me to make sure I wasn't in pain. At the end of the procedure, he went over what I should expect in the coming days, prescribed some pain medication, and sent me on my way. In the end, my recovery period was much shorter than anticipated.All in all, Dr. Fagin and his staff were very friendly and professional. I would leave 6 stars if I could - highly recommended!
Nikhil Agashe
03:00 22 Mar 22
Dr Adam Fagin is amazing. I went to him with a complex case, my wisdom tooth extraction was attempted by another dentist and it had broken. I was in a lot of pain. Dr Fagin was able to accommodate me next business day. The surgery was scheduled a day later. He explained me all the options and listened to my concerns. Together we chose the best course forward. I am now recovering well.Thank you for excellent service!!
Ginna Busey Arnold-Lazar
06:11 31 Dec 21
I had fractured a tooth just before Christmas and it could not be saved. My dentist called Dr. Fagin’s office and they made sure that they gave me an appointment right away. My tooth was extracted the day before Christmas Eve.My experience was very positive, the doctor was thorough and his staff was so kind to me. They took care of every detail.So grateful!
Jessica Graham
01:16 24 Dec 21
Dr. Adam Fagin came highly recommended by my primary dentist for Wisdom teeth removal. Being in my 40's, my lower wisdom teeth were very close to the nerves. Dr. Fagin and his staff answered all of my questions and explained all potential risks. I found him to be personable, knowledgeable, and clear / understandable.I truly appreciated their communication throughout the procedure and keeping me calm through the onset of the anesthesia. I awoke relaxed and felt so comfortable in the warm blanket provided. My recovery has been smooth simply by following the post-op instructions provided (and thanks to the ice cream gift card!).One week later, I visited for a post-op check-in and am feeling so great and having a smooth recovery. I highly recommend Dr. Fagin to anyone looking for a top-notch oral surgeon, especially for wisdom teeth extraction.
Vanessa Meyer
01:47 22 Dec 21
I was extremely nervous to know that my 2 year old was going to need her tooth pulled that broke from a fall the day before thanksgiving. The stuff in Dr. Adam Fagins office was quick and fantastic on getting us an appointment. On arrival they were kind with check in. We then got taken back to meet Dr. fagin. He explained everything and answered ALL my questions. I felt very comfortable with everything that we discussed so we went ahead and started the removal process right then. I was nervous of course so I talked a lot and he didn’t seem bothered. He was so calm the WHOLE time. Overall this whole experience was better than I prepared for and my 2 year old is on happier than ever.
francesca viale
02:14 04 Dec 21
Wendall Mascarenhas
20:04 26 Nov 21
Dr. Adam Fagin is truly one of the best surgeons in the state! He specializes in corrective jaw surgery and takes the time to explain his work-up and process with you and the family. He is fellowship trained and has a proven track record of success. I recommend him without reservation!
Jenny Yoo
02:13 20 Nov 21
Dr. Adam Fagin truly provides compassionate and excellent care. My family member received an oral surgery from him, and every step along the way, he was informative, inviting of questions, and extremely responsive and caring. He also has a wonderful staff team who are caring and professional.
Patz S
01:00 18 Nov 21
I would defiantly recommend Dr Fagan. He and his staff are truly amazing. They were able it fit me in for an appt the same day I called. I was in excruciating pain from an infected tooth. He was able to remove the tooth with little to no pain. His followup appt was pleasant and he really took the time to explain any questions that I had.
Harkiran Gill
20:23 12 Nov 21
I came to Dr. Adam Fagin to have all 4 of my wisdom teeth removed in one go. Dr. Fagin truly went above and beyond in providing services and making sure I was comfortable before, during and after the procedure. The procedure was executed efficiently (less than 2 hours) and I was given very detailed and clear post-op instructions. After the procedure, Dr. Fagin promptly answered all my questions and addressed any concerns I had to make the whole process of having my wisdom teeth removed as painless and seamless as possible! He even called me after the anesthesia wore off (such a nice touch!) and checked in on me during the weekend after my surgery and the following week - which helped me keep my sanity and not worry so much after the procedure. I cannot recommend him highly enough! Thank you, Dr. Fagin and the entire staff for making this hard and annoying procedure/recovery as quick and hassle-free as possible! Dr. Fagin truly is a rockstar at what he does and his kindness and patience just make him that much of a better doctor!
Jay Long
18:34 06 Nov 21
The entire experience was excellent. The staff was very efficient and thorough. All of my questions were answered. Dr. Adam Fagan was my surgeon and did an excellent job. I was experiencing a lot of discomfort before the procedure, and now I’m recovering with no issues. I would highly recommend this office for anyone requiring maxillofacial care.
Amurao Annamarie
00:43 29 Oct 21
9yr old daughter had to undergo extractions to remove baby molars and premolars underneath. Was in and out of surgery in 40 min, and she wasn't in any pain post surgery or even in the days following. For young kids, dentist visits are scary enough but surgery extractions could be traumatic and this was not. Nicely done, Adam Fagin! The personal call to check in on patient's recovery after the anesthesia had worn off was very much appreciated too.
Alexandra Bayeva
05:11 14 Oct 21
I had an emergency two molar teeth extraction with Adam Fagin. The extraction was considered somewhat complicated due to the long roots of my teeth. The doctor confidently performed the procedure that took less then half an hour. He was very attentive and let me rest when it was needed. I also appreciate very much that Adam Fagin was honest and upfront during the discussion of bon graft necessity. He took his time explaining things and gave me time to take the decision. My extraction site healed well, —I did not have swelling and had very little pain.I am very happy with dr Adam Fagin work!
Heather Rene
01:53 12 Oct 21
Dr. Adam Fagan is the best! My 16 year old daughter needed to have her wisdom teeth taken out. One of them was causing her pain. He got her in right away. His office staff and assistants are so kind and helpful. They explained everything to us so that we knew what to expect and they also went over the aftercare.The removal of the teeth was a complete breeze! She had them taken out this morning and she’s already up eating and drinking. This is night and day compared to my 20 year old daughter who went to an oral surgeon in Redwood City. I wish we knew about Dr. Fagan sooner!Trust me, this doctor knows the latest and greatest techniques because he’s younger. My dentist told me that when he referred us and he was 100% correct. We will be using Dr. Fagan for all of our future needs for our family.Oh and he gives you a gift card for Baskin Robbins to use when you are recovered from the wisdom tooth removal. So cute! A nice touch! 💜
Sue Subbotin-Riviello
21:10 07 Oct 21
Adam Fagin orchestrated a complicated procedure with a wisdom tooth root curled around a nerve. It was performed seamlessly. Dr Fagin has wonderful bedside manner as well. I recommend him highly.
Brittany Cadwalder
23:45 06 Oct 21
Amazing and caring staff. I got my wisdom teeth out (not under anesthesia) and felt extremely comfortable and safe the entire procedure. Aftercare instructions were detailed and clear. Follow-up appointment was also helpful. Would highly recommend this practice!
Graham Phisher
21:36 06 Oct 21
Well I had to have my number one tooth extracted, and apparently to most doctors the extraction was labeled "tricky" due to divergent roots and a another matter. One dentist of no relation to Fagin or his office tried pulling the tooth himself for around a hour with no luck, another dentist again no relation either said the tooth would need to be cut into pieces to be extracted... However the day after all that I arrive at Fagin's office and he tells me he's just gonna pull the tooth out, and I'm thinking there is no way given yesterday. Faster than I can write this review though, he had my tooth out, pretty much in minutes. With all that said I cannot recommend Fagin enough, you can tell he's super sharp and on the ball.
Nasyeli Salas
00:48 05 Oct 21
Yesenia Rivas-Henriquez
00:05 05 Oct 21
Sydney Stoker
20:39 28 Sep 21
Paden Roder (RoderBro)
21:47 27 Sep 21
Dr. Richard Fagin and Dr. Adam Fagin are extremely nice, patient, and professional surgeons that I couldn't recommend more.
Ugochi Umelo Ogwo
03:38 27 Sep 21
My mom visited Dr. Fagin for an emergency procedure to complete the extraction of a tooth. Even though she came with an emergency case and without a prior appointment Dr. Fagin showed great flexibility and acted with the utmost urgency and professionalism, putting her at ease. His specialized skill and personable nature were evident and he did a great job in a short time, calming her the whole time. I highly recommend Dr. Fagin and we are grateful that he stepped in for the difficult extraction of her cracked tooth.
Amelia Stoker
19:56 24 Sep 21
Becky Low
00:04 05 Feb 20
Dr. Fagin and his staff are great! I had all 4 impacted wisdom teeth removed at once. The procedure itself was quick (in and out after 2 hours total) and very well executed. The office provided detailed aftercare instructions, which helped tremendously with my quick recovery. The cost of the procedure included some cleaning supplies and 2 follow up visits, which was a pleasant surprise!
David Stensen
17:02 21 Dec 19
Very kind staff. They took care of me straight away. Quick, accurate diagnosis and solution
Kathleen O'Connor
18:58 08 Oct 19
Yuchen Wang
00:05 21 Aug 19
Emil Camozzi
21:21 20 Aug 19
Amazing staff and office. The best! Calm and confident Advice makes the difference!
William Medwid
00:41 28 Jun 19
Friendly and helpful - no complaints from me.
Juana Martinez
00:05 21 Jun 19
jonathan lew
02:51 11 Jun 19
Sheena M
00:14 27 Apr 19
Meiqi Mo
01:08 12 Jan 19
Wonderful doctor and his team! Very nice and professional. I feel very comfort all the time.
moniG
21:12 07 Sep 18
Very kind, patient office. The doctor and assistant were both so nice and open to any questions. I felt very comfortable and safe in their hands when I got my wisdom teeth extracted. I trusted them right away to not cause me any unnecessary pain and I had a very smooth surgery and recovery!
Cody Hopkins
18:02 13 Aug 18
Brent Weatherall
21:04 10 Aug 17
Did wonderful job on wisdom teeth removal. Perfect amount of general anesthesia. Minimal pain afterwards, and had no complications. Very professional and friendly staff.
jerry schreier
03:05 15 Apr 17
I had a Very good experience with Dr Fagin' . The staff is also very helpful and friendly . I would highly recommend this Doctor and office .
