NOLA in September?
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I have not gone there yet...maybe going for a revision pending if the center and I can work something out. I remember I did ask re anesthesia charges and was told I was in network. ..but I know my insurance fairly well ..and thought it wasn't likely. .i have been through 6 surgeries. Vicki told me to call the anesthesia group that they use.... i am definitely not in network...I am glad she gave me their name. ...she was concerned. Further the center also charges for anes. because they use nurse anes. (so that is how I understood it.) .....not uncommon. .However I am out of network for that also. My insurance won't pay for a nurse anesthes. ....or at least billed by a nurse anesthes as a provider bill. I did mention that to them. They will likely cover an anesthesia charge...but not a provider that charges billed under a nurse anesthes. So confusing....... but either way- if they do cover only 50 percent is covered.
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bdavis - they plan to use one side of the abdomen (diep) for one breast and the remaining half of the abdomen plus a hip (stacked diep + gap) for the other breast. For me, it is because my L is very concave and is very tight after 3 surgeries. It needs more fat and skin than the R which only had 1 surgery. Isn't it all amazing???
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The Alloderm would be part of the quoted amount. Any employee of the hospital is billed through the hospital and I would imagine be part of the quoted hospital fee. So for me, I paid what I was quoted, plus the anesthesiologist (which usually was in network for me, but once out of network), the breast surgeon who at the time was in network and from another hospital (Dr Stolier).
The nurse anesthesiologist was billed separately to Aetna, but I was never billed when they didn't pay. So I think you are responsible for anesthesia and you won't have a BS... otherwise, I believe it is part of the quoted amount. Perhaps make sure that the hospital billers know that if they bill the insurance company for a dr and a nurse, they may cover 0%. And they should bill it all under the dr if that's possible. I never had any problems getting anesthesia covered for the doctor. My portion was 10% I believe. And the amount of the bill will be contingent on the duration of the surgery. Did they tell you its Parish Anesthesia? I also had a different one once, which was out of network.
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This is Marsha. I'm feeling paranoid about my online presence so I changed my username. Next I'll be removing photos. I don't like how these boards are indexed on google. Other breast cancer boards I've participated excluded their boards from indexing.
Welcome to the other side BetNY22.
Stix and Patty, I'm sorry you are getting unexpected bills. That really sucks. I was asked for a copay before surgery I didn't expect on stage 2. They said it was my hospital copay but I thought it was BS because I already met all of my deductibles but it was only $250 so I didn't fight it. I hope you can get this straightened out. One of the reasons I went to nola with confidence is the ladies here assured me I would not get balance billed. As I've seen the bills come in that would be really frightening.
I'm interested in exploring scar laser treatment. Dr S did such a nice job correcting all the scars from previous surgeries, but I want to make them as nice as possible. Has anyone tried this and feel it was worth it? Also of course they won't tell me how much it costs over the phone. I want to have a ballpark idea. I know it varies by what you get done and area. I don't really have time for this so I want to Have an idea about the cost. Pm me please if you don't want to share here.
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All of this talk about coverage is scary. My insurance company has agreed to pay in network since this procedure is not offered in my area. NOLA is roughly 100 miles away. They say the in network exception extends to all services related to the surgery. What questions do I need to be asking?
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I'm scheduled for a L mastectomy with temporary implant with Dr Stolier and Dr Trahan on 3/14. I live right outside of New Orleans so don't have to travel too far. After rads, I will have gap flap recon, I'm a little nervous about it. Also, if you don't mind telling, did you have to put down money up front and then see what your insurance pays? I have out of network benefits, but it seems like they still want you to pay something up front.
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Yes parish anesthesia. Either way parish or any other group ...i am out of network ( 50 percent ) unless I get care at 3 hospitals near me...In which I work at one of them. The hospitals are connected ...so one doctor reads the others notes and I hate to say it but they don't deviate from each other......it's like a club. You don't always get an unbiased opinion when you get opinions from the same health care system. ..you get stuck in one culture. My friend who was under other circumstances said the same thing.
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m1970...i have not gotten extra bills... i am trying to figure out what my bills will be b4....If I go there. I am definitely learning alot. I am a financial freak I guess....i need to know everything b4 hand.. Large bills large copay and unexpected bills give me anxiety.
. Secondly my job is very slow right now....yes.. who ever thought health care would be slow...i am sure there will be layoffs in the near future. I have made it through 5 rounds in the past 4 years. We all think with decrease reim. And the new health care system ( people losing their ins now have high deductible s ) are not coming to the hospital for elective procedures. This new health care system thus far seeks to be a big old mess 0 -
m1970...don't know anybody with scar treatment...let us know when you find out more.
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Marsha,
Reach out to NOLA and ask about the stuff they GIVE YOU for reducing scars. I had mentioned my "red, angry" scars to Erin (Dr. Sullivan's PA? Or nurse?) and she mentioned some stuff...which the name escapes me. I believe it is prescription, but she had offered to mail it to me then said "wait, you are Stage 1 surgery...don't bother yet" or something to that affect. Meaning I was going in for a stage 2 so don't try to fix what they might be recutting.
Gramof2boys...I imagine you should have gotten your price quote by now. I was given a price, upfront, for my out of network expense. I was told that was all I was responsible for. These other bills are a bit of a surprise. But again, maybe I we hearing what I wanted to, or someone from the hospital side never called me to tell me otherwise? So I would recommend you call, ask what you will be paying for and then go through the list: outside breast surgeon (for my mastectomy) , anesthesiologist, CT Scans/other scans, tests, labs,
Unfortunately there is no "menu" on pricing for these things....so they can't give an exact figure on anesthesia (our surgeries are all different times), or scans (maybe not all the same tests).
Call and ask for Vickie, she should be telling you your costs related to most of it anyway.
Funny how the hospital side called me this time around to tell me what I can be expected to be billed for separately. I wonder if the Center was getting a lot of complaints about these unexpected bills? Maybe I shouldn't have paid the last bill and called the center to complain! I also wonder if they thought they were going to get so much more from my insurance company as Vickie had said "they pay really well" when she had first given me my price quote. I didn't think they did., and by judging from the statements coming flying through the mail they don't! Maybe they decided to send me bills now? Oh well, I will pay a visit to Vickie...I have to figure out if I want to bring all my statements ,,,,it might out my luggage over the weight limit! Lol
Pat
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Vicki certainly has been very helpful to me once I mentioned I was out of network for anesthesia. She told me to call parish anesthesia and I talked to the hospital billing... she told them to call me... she seems really concerned. She has a really hard job. Who really wants to give people money numbers when they are ailing... i would not want to do that....
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Marsha - I have had laser on scars and it worked very well. They lightened and flattened quite a bit. I would suggest that you wait before treating your flap scars (give it a year), just to see what happens naturally. It is expensive and not covered by insurance. I have been using mederma gel and brown 3m micropore tape on my breast incisions, nothing on my ab. Ab is a mauve purple and may need treatment. Breasts are coming along slowly, but Dr. M asked me to give it 2 years to see the final natural result.
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Jeanine gave me Kelocote to use in my scars after Stage 2, and said I could just ask for more when I need it and they will mail it to me. I have to wait four weeks post surgery, so I haven't started it yet. Betsy has had good results on her scars over time, but I forget exactly what she used. Maybe she will chime in again about scar care.
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I got a bill for $1350 for pathology the other day. I will be checking this out today, and calling whoever will listen to me. My out of pocket is $8000 before insurance is supposed to cover at 100% (but NOLA is out of network; they told me pathology and anesthesiology is in network!), and I'm now at over $11,000 and I haven't had Stage II yet. I'm freaking out here!
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When I researched my insurance with Vickie she gave me phone number for Parish Anes. Parish told me my insurance was in network for SOME of the anesthesiologists. They are randomly scheduled so no guarantee you will get one in network. This is what I was told 18 months ago so this may no longer be the case. I ended up going elsewhere where everything, docs, scans, tests, nurses were 100% covered by my insurance. Medical bill anxiety been way too much part of my life, too.
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tlbradyful- you should be fine if your insurance says you are in-network. I would call them if you have not already. They do have a right to deny later- But from what I have read on here NOLA usually goes after them. No personal experience myself though
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Will be posting before implant revision- pictures soon- If I can figure how to post on the picture forum. Not 100 percent sure where I will go for revision yet. You can post your comments- I am not one stinkin' bit fragile. I know they aren't great. The point of the pictures would be to see improvement afterwards....
Will try get them up in the next couple of days....
Stix
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Ok, I was freaking out over the wrong bill. Hah ... I have enough to pay! It was the mastectomy surgeon's bill. The center told me I would have to pay him $1150 and its actually over $1300. I guess I thought his office and the center had an agreement, and I was under the impression that if Vickie said this is the amount I would have to pay, it was because of their agreement. Not so, says Fuhrman's office - they said its an estimate only. I'll have to call Vicki.
Anyway ... the bill that BCBS did not pay that is IN network is the pathology bill. I've met my entire $8000 out of network costs, so they should have paid it. I will be filing a dispute.
This money stuff really causes a lot of anxiety and stress.
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By the way .. is there no one that helps people like us that have high out of pocket costs? I've looked, but couldn't find anything,. Just thought I'd ask. I am a single Mom, but I'm helping my youngest get through college, so there is no one for me to fall back on. Sure would be a help, even just a little.
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Maggie it happens. ... glad it is working out..
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Maggie, I had Dr. furhman too. He did a double on me, so $3000. I had been quoted $1,000 from Vickie. I had spoke with Vickie and told her I was disappointed (mad, whatever) and I had spoken to Oschner, which does the billing for Dr. furhman. I have not received another bill, but I suspect, in time, I will.
It did have the "appeal for financial assistance" on the back of the Oschner bill if I remember correctly..I didn't meet the criteria. I learned long ago not to judge single, married, kids, no kids. We all struggle to make ends meet and have a better life. Bigger income means bigger house payment and credit card debt I'm sure! I've got 4 kids, youngest is 11 and I am retired...it sure stinks! I hope you can find something. Nyou might try the moderators, they can point you in the right direction.
Pat
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Maggie,
That's very unusual for a pathology bill to be denied for payment! Many times I have found that someone along the way has submitted the wrong code, etc.
What does your EOB statement say for reason for denial? Have you called insurance company?
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Patty, my bill was about $4300 ... the $1300 is after BCBS "discounted" it because they are in network, and the rest they put toward my deductible ... doc charged more than Vickie said, is the problem ... I will send a check for the $1150 I agreed to, and then talk to Vickie. I have Stage II coming up April 3, so I'm kinda scared. Although ... the insurance company shows me as having fully paid my max out of pocket of $8000 finally.
Pink - they did not deny the bill ... they put it toward my deductible/out of pocket, which I had already met. I'll be talking to Blue Cross, trust me.
All in all, this cancer has cost me a little over $11,000 - without counting in the travel costs to NOLA.
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cancer is expensive. I think I will market a t shirt and put donations out for some of the profits !! I LOVE THAT IDEA. . I paid 600 dollars for the remainder of my bill for the bra gene in 2010 then I had 3500 of bills for Second opinions at university of Michigan in 2010. "Cancer is expensive " t shirt. Do you think anyone would buy it? I could donate 5 he majority of the money...After my bills r paid.
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As I told Stix in a PM, through all of my surgeries, one anesthesiologist from Parish was out of network for me, and all other surgeries were in network. I had Dr Stolier while he worked at Omega and he was in network for me. The hospital is treated as in network for me as well. At the end of the day, they really do stand by their quote, but you have to remember what the quote covers. I had a Center (doctor) quote and a Hospital quote (which was zero). In addition to these quotes are: pre-op tests, breast surgeon, anesthesiologist and his/her nurse. With my first stage I, I met my MOP for the year, so I paid what I owed Dr D and all else was covered by Aetna. Since then, no breast surgeons, scans or pathology... so my only "surprises" have been anesthesia. It may be worth a question about assuring that you get an in network doctor, or a waiver in writing from Parish.
About scars, I have used a lot of stuff. The 3M micropore tape, kelocote, the silicone gel strips. All of it has been distributed by the Center. I kind of mix it up. One week using one thing, one week doing something else. And the silicone strips don't work well on the buttock... it would get moved around too much. I just posted updated pics on the forum... it shows my scars from November which can be compared to the scars that haven't been touched since January.
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Thanks besty. I think i just wanted to understand the process. For some it may not be a big deal....A couple thousand or so... Etc. considering the whole picture of cancer , they are great doctors, and the multiple stages But I like to understand and like to be informed 100 percent Thanks for clearing that up. And ...what type of waiver are you talking about besty....?
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There are ALWAYS variables with insurance. ..sometime not in your favor and sometimes in your favor. For example I went to u of M for a second opinion prior to my prophl. Side last April . Because I was having symptoms they did a mammogram and an ultrasound.. well my insurance is only suppose to cover 80 percent and they should not of even covered the mammogram because I already had one completed that year. Secondly I should have been charged radiology fees. Well someone wasn't paying attention...... and they only made me pay a 50 dollar office visit. Now that wasn't the case when I had cancer on the other side in 2010.... i had 3500 dollars of second opinions ...mainly from testing more biopsies, radiology reads etc. Not sure why they didn't charge me last april...maybe there was a kind heart behind the approvals that day....or they thought I have already been through the ringer. So I guess the point is as long as you have a general idea that you MAY get an extra 1000 charge....it would be nice to know b4 hand. I asked about anesthesia previosly....because I have NO idea how much they would charge at an out of state fa ility...... Not sure if it would be a lot higher than what they charge around the area i live....so I was a bit concerned wanting to know if I can even afford it....considering I am out of network for parish.
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What I am saying, is if you were in network with some Parish docs and out with others, maybe get an agreement from Parish beforehand saying they will treat all docs as in network. Not sure they'd do it, but always worth a question. But out of network is out of network.
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yes. I am out of network ..but that may help someone else. Thanks Betsy
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Hi Quick question
Has anyone had benign cysts form in their flaps???
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