For Doctors or Healthcare Professionals


If you're facing challenges securing funding for a patient's orthognathic surgery, we can help.


OGS Appeals works with healthcare professionals to navigate complex funding processes, including clinical commissioning guidelines and diagnostic criteria. We’re familiar with the requirements of various insurance providers and can guide you through the process to ensure the best chance of success.


We are also experienced in dealing with insurance companies across Europe, helping to clarify coverage and appeal decisions. Some of the insurance providers we work with include:


  • Allianz
  • AXA
  • Bupa Global
  • Cigna
  • Zurich
  • Aetna
  • Generali
  • Mutua Madrileña
  • MSH International



If you're unsure about how to proceed with a particular case, feel free to refer it to us. We'll handle the paperwork and liaise with the insurance or funding bodies so you can stay focused on patient care.

FAQ for Doctors and Healthcare Professionals

General

  • Can I refer a case directly to OGS Appeals?

    Yes. We welcome referrals from surgeons, orthodontists, maxillofacial units, and administrative staff. We handle the funding and appeal process so that clinical teams can remain focused on care delivery.



  • What level of clinical information do you require?

    We typically require diagnostic notes, clinical letters, imaging reports, MDT summaries (if available), and the treatment plan. We may also request documentation supporting medical necessity and previous funding decisions or rejections.

  • Do you assist with interpreting commissioning criteria or coverage policies?

    Yes. We routinely analyse local commissioning guidelines, EU regulations, and insurer medical necessity criteria. We can advise whether a case is likely to meet eligibility thresholds and what documentation is needed to support that.



  • Are you familiar with insurance policies and exclusions?

    Yes. We have experience dealing with a broad range of European and international insurance providers. We understand common exclusions, pre-authorisation hurdles, and appeals procedures.



S2 Route (EU Regulation 883/2004)

  • What is the S2 Route?

    The S2 Route allows insured individuals in one EU/EEA country to access planned medical treatment in another, with prior authorisation. The home state covers the cost under the terms of local public healthcare.



  • When is S2 appropriate for jaw surgery?

    S2 is relevant when the treatment is available under the public health system but subject to delays, or when equivalent treatment is not available domestically. Clinical urgency and patient rights under EU law are key factors.



  • How does OGS Appeals support S2 applications?

    We assist in drafting clinical justifications, framing the case within EU legal standards, and preparing the full application for prior authorisation. We also liaise with both referring and receiving providers where needed.



Private and Global Health Insurance

  • Do you handle appeals to private insurance providers?

    Yes. We prepare structured, evidence-based appeals that address the insurer's stated reasons for denial and align with their policy language on medical necessity and plan coverage.


    Which insurers have you worked with?

    We have worked with many insurers across Europe, including but not limited to:

    • Allianz
    • AXA
    • Bupa Global
    • Cigna
    • Aetna
    • Generali
    • Zurich
    • MGEN (France)
    • DKV (Germany and Spain)

  • Do you assist with pre-authorisation requests as well as appeals?

    Yes. We draft and submit pre-authorisation requests and provide supporting clinical documentation to reduce the risk of rejection at the initial stage.



Public Healthcare Systems

  • Can you assist when treatment is rejected by a national health authority?

    Yes. We review rejection letters, identify gaps in the clinical justification, and draft appeals that target the specific language and criteria used in national health policy frameworks.


  • Do you handle cases across different European healthcare systems?

    Yes. We are familiar with public healthcare funding frameworks across Europe, including the statutory insurance systems used in Germany, France, Spain, the Netherlands, and Scandinavia. We advise on eligibility and assist in drafting evidence-based submissions in line with local requirements.