NOLA in September?
Comments
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Maggie - just don't expect much of TSA. Offer to touch the drain bulbs so they can scan your hands. That can help. Just remember that it is better for them to check carefully than for a bad person to get by with forged documents.
Coding can be crazy. I got a call about 2 weeks ago from the local hospital for $7,000 for the nuclear stress test the Cardiologist had to do prior to surgery. He couldn't do any other stress test because the old implants blocked the signals. I told the hospital that they really needed to check carefully as the tests must have been miscoded when submitted to insurance as they were essential medical evaluation. Still waiting, but not stressing.
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Maggie -- so glad you got the neck drain out! That sounded so painful!
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Dr. M actually told me she likes to keep patients on schedule at 3/4 mo. apart. My stage 2 was 3.5 mo. Later and I had no complications. My 2b was scar revision and 2c in the fall will be final fat grafting. So, there will be 7 mo. between my lipo and fat grafting. No complications except for drain site taking its time to close. It finally has.
I need to be done for insurance reasons also. I met deductible last year and this year. That is enough!0 -
I had no real insurance problems with stage I, Ib and II... I think in all of that, maybe 14K wasn't covered.. That was in 2011. The Center/SCSH just absorbed it. But my stage IIb is another story. Vickie said that the more surgery you have, the stingier they get with pay out. I think they covered a lot of Dr D's bill, but the hospital bill not so much. Of the 110K billed, I think they paid 30K, so explanation of benefits says I owe 79k or something... plus another 6k for Dr D... Anyway, I called Vickie who said that the first round of submittals are read by computers, so lipo is generally denied. Then they appeal and it usually gets paid. I offered to get involved, but they said it wasn't necessary... of course, that day may still come. It also made me nervous cause I now have a stage IIc in November - I have hotel, plane tickets and expectations. So it better all work out. I do trust it will... I haven't done anything absurd. I did question Aetna about one denial and they said that collegen was used as a filler and that wasn't specifically mentioned in my pre-authorization.
As for timing between stage I and II... many women need to get surgeries in in a timely manner due to insurance. So they say at least 3 months. But waiting longer is always better if you can do it. I had my stage II 3 months post DIEP (4 months post GAP), and I was still pretty swollen. So in retrospect waiting would have been best. So I waited 14 months until my stage IIb, and will wait 10 months to IIc.
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Hello everyone. Still celebrating from Wednesdays post-op. Dr D pulled 3 drains & I did a happy dance for the nurses. He also told me I could wear an uncut bra as long as I watched it. Guessing "watch it" probably meant every couple of hours instead of at the end of the day after a city tour, shopping & concert at Lafayette park. Dummy me. Ended up developing & bursting a blister on the side of the right nipple. Center told me to put on neosporin & keep it covered? Thought I would need to dry it up & go back to cutting holes. Confused but much more watchful now.
As far as waiting for stage 2. I'm scheduled Aug 14, exactly 12 weeks after stage 1 & specifically asked Dr D because of all the talk. He said, like others have said, 12 wks is the minimum & each person is different. He felt because of the way I was responding so far that I'd be perfectly fine. I'm also one on a time budget with insurance & have things in place so i'll probably go ahead plus if I wait too long i'll never go back!
Karen, you looked awesome yourself! Hope your flight was uneventful.0 -
I'm having my stage two 12 wks after my first stage on June 17. I'm hoping this will be the last and onto tatoos in Sept. I'm wanting to get all this over with by the end of the year since I've met my out of pocket now and insurance pays 100 %. So far my insurance has paid Dr. Trahan and Dr. Stolier and the anesthesiologist. Still waiting for the hospital, Dr. Dellacroce and the PA Amy G. fees to be paid. They have filed, insurance is taking their time but I can understand why that's a lot of money to let go of.
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Oh.. Amy G was denied for me... Then they paid out like $500...
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Oops... just looked again at my Aetna website... Dr D was covered about 50%... That's when Vickie said they would keep appealing.
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What a relief to see that you all are fighting insurance too. I am most stressed about that. I have a surgery date that is in June, but have not heard from Vicke in almost two weeks. Dr. Masseys office wants me to do pre-op stuff, stop meds, & complete travel arrangements, but I don't want to do any of it if this surgery isn't going to happen. I am starting to think it would just be easier to let the local surgeon do a lumpectomy.
Sorry, vent over. Sharon0 -
Thanks for all the feedback about time between stage 1 and 2:) I feel like all my swelling is gone. I hope it's all gone from my new breasts! I don't want them to get any smaller. My pre-masectomy bras mostly fit. Lefty is a little bigger than righty. Stage 2 should take care of it.
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Sharon... Go for it!!!
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Bdavis - does " go for it " mean you recommend lumpectomy?
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One time when I looked at my insurance claim page they had paid Amy G. fees and boy did they cut her way down from what she was charging and I guess someone wasn't happy with that amount and so now it's back to "in process".
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Sharon- I agree with Betsy. Just do it. Get the tests, make the travel plans, stop the meds. I received a direct denial before surgery due to lack of information. Called Dr. Massey's office and they got right on it. After Stage 1, I received an accident report form from insurance so they could go after the other guy's insurance. Apparently the removal of damaged implants uses an insurance code that is in a group that identify accidental injuries. Again, Dr. M's officed helped me with it.
I am on a 16 week schedule. Stage 1 in November, 2a in April, 2b will be in August and 2c in December. Hoping for tattoos in April 2014 to ice the cake.0 -
MartyJ..icing on the cake..love it!!! It truly is a process:)
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Ssla01,
Is your insurance in network?
Can hjhg0 -
I'm so excited to be hosting our NOLA sister, Eva Moon, tomorrow night for a local performance of her one-woman musical, "The Mutant Diaries: Unzipping My Genes." It will be a hoot! I'm glad to finally meet Eva!
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Pinkheart- my insurance is not in network, but the insurance company granted an in network exception. So it seems to me that should take care of it. I haven't heard from te Hospitals insurance person again. I was so uninformed to believe that if I got the exception, it would all be easy. :-(
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Sharon.. to be honest, no one or not many are in network, so you are fortunate. Mine is out of network but is managed by a third party THREE RIVERS. I think in general it works out, but the path to get there can be rocky. The gals in NOLA are excellent at getting paid.
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I have not received any amount due bills from any of my 3 stays at st charles and they total over $400G billed. My insurance payments have been horrible and I worry that they are coming to get me. It is not fair that we must worry about the financial stuff.
Got a date for stage 2a! August 19th in Charleston! Perfect boobies here I come
Maggie 20 -
Maggie - let me know what info I can share about Charleston. My Stage 2n is on Aug 6.
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Oops. That's 2B. I am not up to N and hope never to be.
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LOL Marty - was doing the math and you'd be hard pressed to get up to N already!!!!
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marty---hahaha. I hope no one gets up to N. Thanks I may hit you up for that info
Maggie
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NO Stage 2N's ! lol
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I went for stage 2, 12 weeks to the day after stage 1. All went well, no problems. I couldn't wait for it to all get finished.
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Pretty sure there'd be insurance issues with stage 2n
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Maybe 2 n = two nipples?
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Is 2n when they do a recall because insurance hasn't paid?
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LOL Patty!
Or 2n = 2 NICE!0
