NOLA in September?
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I don't exactly know how NOLA does that out of network. I am appealing my insurance to give me in network for two second opinions that are out of network. They have 30 days to respond. I have not heard back from them yet. If i do get In-network benefits for an out of network physican/facility- does that mean they will pay "their charges in full" versus the a "negotiated" fee.
Anyone have experience w/ this?
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I wanted to say I went to my nola consult. I stayed at the clarion. My first impression was fair at the hotel. But as a got use to the city I love the hotel and the cheese cake bistro attached had awesome food and cheese cake. The room was big too.
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More importantly, how did the consult go?
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It went fine. Dr. D was very nice and down to earth. It seemed like we were on the same page of getting this behind me and moving on. The staff was good also. I thought it may be snooooty there. But, not at all. Very good place to go thus far.
And, I love the city New Orleans. The city made me forget about everything
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Oh, they are not snotty at all. They are the nicest people I have met during this whole ordeal. I met Sullivan first and his self confidence gives you a tremendous comfort level that no other doctor gave me. And Dr. Stolier. I love that man.
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I wanted to say that I found my experience at NOLA as far as billing to be the exact opposite. I have CIGNA, which makes a big difference, but I've found that they have always over-estimated costs or given a worse case scenario. I haven't had to make deposits. They are fighting a rejection on a lipo code which I was told upfront I'd have to pay--they're fighting because it was so needed to replace fat necrosis. Again, I know I'm very lucky to have CIGNA since they're in network, but I just want to share such a positive experience. Of course, everything there was pretty much positive!0
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does anyone know how you followup with NOLA after surgery for revisions? How long do you have to stay in town? What if a coomplication develops quickly like a hematoma or an infection ?
thanks.
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Stix
That is a great question. I've wondered the same thing myself. Does a local ps where you are located agree to see you?
G
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I had a hemotoma the day after my original surgery so I was still in the hospital. NOLA called me frequently to check in but I had no complications. I think by the time you leave town, you are likely to be able to tell. I have read that some people have a local doctor lined up just in case. My team made it pretty clear they were not interested. (They are no longer in my employ, btw).
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I am appealing to go out of network for a revision the appeals committee wants me to send them a pic...because they want to make sure that it is actually a medical necessity versus 'I don't like the reconstruction 'I have sent them two letters from my current ps saying I have thin skin from and implant bottoming out. I have had 3 failed surgeies...2 were revisions.i have had 3 plastic surgeons work on this without resolution to the problem. I told them I would send pic....but now thinking ... the pics don't give it justice of the protrusion assymetry..... and rippling. ...what does everyone think about...i will tell them that i will meet them in person and show them the reconstruction... I really would like to make them feel uncomfortable These people are not ever doctors ... I really feel uncomfortable with my pictures being in someone else's hands that works at 5he same facility as i. LASTLY they want to send my pictures to another dr.that is a sister hospital to the appeals committee hospital.doesn't this sound odd how they want to send my pictures around town in the mail ??? ANY COMMENTS are encouraged. Please respond
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Stix, how about sending them a video clip where you talk while demonstrating all the issues?
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hi Merrell, thanks for the tip.
But, I already wrote them a letter saying they can look at it in person. In addition, they can send me to a ps of their choice to verify the assymetry. I figure if they are going to deny me, they should see me in person and see that I am a real person and not just written words on a piece of paper. Is the gutsy ? I think so. But, I don't care. They can look at it all they want- as long as I get it paid for. I can do some education on womans health- Presently I am only asking for the 2nd opinions. Next week I am going to have my doc write a letter stating there is nothing more he can do for me...which will lead to surgery out of network.... hopefully.
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Does anyone know where you get get good quality pictures developed from the waist up? my appeals committee states they will not accept me coming in to have them view. I don't have a quality printer or camera. And, my digital camera just died. They want to make sure its a medical necessity even though it has been confirmed by several physicans that it is assymetrical.
Any comments would help thanks
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Sorry you are having such a time with this, Stix. Might you have a trustworthy friend with a digital cam who could take the pics for you? Then you could edit them on your computer for precision. I can't imagine shelling out $$$ just to get some good pics. As for printing. . .I think if I were in this situation I would have them developed at a Walgreens/CVS/RiteAid and pick them up wearing a hat and dark sunglasses? Seriously, I'd give it my best effort. Hope you figure out how to do it.
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Hi merrell girl Most don't develop any pictures of the nude body and if they did I would have to go through a manager which would bring more attention to me and the pictures. I think I found a solution tho A friend of a friend is a photographer w. a descent camera. I think i may have her take them. Do I know her...? NOPE. lol. It will be a blind pic without my face. Therefore, I am concerned....yet not too worried.
I have no pride anymore. bad things happen to good people. It is what it is.
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My cell phone takes great digital photos. I used it throughout my pre surgical and surgical process. I can not imagine that they want photos, just digital files. Those committees meet online, not in person. Having someone else take the photos means they can adjust the angle and lighting more easily than you can to get the best shots of the "problem" areas.
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Hi marty. My insurance is a self funded insurance plan . Most larger corporations are self funded. This means my employer pays all the claims of all of its employees....so the employer actually makes all of the decisions on if someone can and cannot go out of network. And yes... they all meet together... its my appeals committee where I work. I wish it was digital. Then .. I could send them via email. I think it is in violation to send pictures through my work email....hence they are requestin photos the appeals committee where I work. My appeal was only to pay for two send opinions. They are over the 30 day allotted time to give me a decision on that....their only response wax we need pictures. Along w. These pictures I am going to request they let me go to the surgeon of my choice and that they support me with all costs associated with t he surgery including but not limited to upfront costs, claims costs, balance billing costs anesthesia costs and facility cost.... anybody willing to comment on that ...would love to hear from u.
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just an fyi I found out... specific stores will develop pictures for you from the waist upward from your camera. I called a ton of stores and one in particular seems extremely good attentive to medical needs. . If anyone needs info on that plz. PM me.
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Hi Everyone,
I am here in New Orleans! I thought I was going to have just a tattoo but decided to do revisions. I'm here now and will be seeing Dr. Blume since Dr. Sullivan will not be here. Can't wait to finish this journey. I will meet with Vinnie tomorrow and hope all goes well as planned.
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Wow, this thread has been sleeping a long time!
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greetings all old and new. Yesterday was my 5 year surgiversary. I always think of this thread at that time. It helped me through that time. I hope all is well for the ladies that were there at the same time as me
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Congratulations, TigSun!
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yay! Congrats to you.
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Congratulations!! Wonder why there isn't more traffic on this thread? It was so very helpful to me
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not sure. I miss reading ppl stories and learning from them.
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Most people post in the private FB group.
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I am new to this thread, sorry if these questions has been answered:
I was going to get the HIP flap in NYC ay Sloan where I live, but after research and some personal advice from others who had this surgery - decided on Nola, especially since I am in network with their Drs.
(I had my mast.+ implants at Sloan and was only a B- happy with results. Figured I only want one flap surgery in my life, should do it right.)
1) How many nights (exactly) does one have to plan to say for - especially, how many nights in hospital and how many in hotel afterwards?
2) Has anyone here ever driven to get surgery v. flying? Nola said they do get a lot of people driving in, but wanted to hear about personal experience driving back... with drains, etc.
3) In your experience, did you need the full 6 weeks for recovery or were you up and around after 3, 4 or less?
4) Is it weird to have to remove the drains yourself or did you get a local dr to do this?
thanks!!
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Hi, GreenJay -- here's my $0.02:
1) How many nights (exactly) does one have to plan to say for - especially, how many nights in hospital and how many in hotel afterwards? My recollection is that you come in a day or two before surgery to have your pre-op appointment, then stay in the hospital 2-3 nights, stay in the area another week for to make sure all goes well, then have a post-op appt and head home.
2) Has anyone here ever driven to get surgery v. flying? Nola said they do get a lot of people driving in, but wanted to hear about personal experience driving back... with drains, etc. I've heard of plenty of folks within a few hours of NOLA driving, but that would be a haul to drive back to NYC post-op. You will just be lying around no matter where you are, but you need to move around every hour to avoid blood clots. Given the need to empty drains and change bandages, my personal preference would be to get home to my bed and bathroom ASAP. I flew from Oregon, so I didn't have any other choice.
3) In your experience, did you need the full 6 weeks for recovery or were you up and around after 3, 4 or less? Even at 42 years old, I did need the full 6 weeks. Two local friends that are about 15 years older than me had bounced back at 4 weeks. We finally realized that the difference was that they'd had their mastectomies years earlier. But also, everyone is different. Hopefully you won't need 6 weeks to turn that corner.
4) Is it weird to have to remove the drains yourself or did you get a local dr to do this? It's weird but not painful or worth driving to the doctor for. As soon as you get the go-ahead to remove them, you will want them OUT. The only real tricks to it are (1) clipping the stitch holding it in place and (2) making sure the drain bulb is open so there is no suction (made that mistake once and it kind of hurt coming out). Sweet freedom when those suckers are gone!
This thread was active for years and a wonderful source of info, but some ladies are now organizing on facebook. There are more current DIEP threads here which would still be applicable to you since they are very similar. Best wishes!
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1) How many nights (exactly) does one have to plan to say for - especially, how many nights in hospital and how many in hotel afterwards?
It depends on what they do. I was supposed to stay 3 or 4 nights (can't recall exactly) but I stayed an extra night because he had to go back in the next day and clean up a hematoma. I was in town for 11 nights total, but could have gone home after 10. I just couldn't get a flight that day. You will have to go the day before for all your pre op stuff. Not sure how far away you live but you may have to go the night before, especially if they want you there early. I am not sure if they will do this, but if I had it to do over again, I would have asked them to schedule my pre op later in the day. I had to be there at 7 and that ensures that I am not going to go to the bathroom that day. Then I had to be there for surgery at 7 and again, well, you know. And of course after the surgery, you are constipated from the pain meds. So I probably went a good 5 days without going. When I had stage 2, they had me come for pre op at 1 and that helped a lot. But again, i don't know if they have all the Stage 1 pre ops early in the morning or not. Tip on avoiding constipation: Magnesium.
2) Has anyone here ever driven to get surgery v. flying? Nola said they do get a lot of people driving in, but wanted to hear about personal experience driving back... with drains, etc.
Can't answer. We flew. I can't see being driven with drains as any particular problem at all. Drains are more of a nuisance than anything else.
3) In your experience, did you need the full 6 weeks for recovery or were you up and around after 3, 4 or less?
I was up and around pretty quickly. I wasn't supposed to work out for 6 weeks so I went very slowly on the elliptical building up my time from 15 minutes to and hour. I think I probably started the elliptical at between 3 and 4 weeks. (I didn't use the arm part).After that (at 6 weeks) I went back to my jazzercise classes. After STage 2, I started the elliptical about the same time but I am able to use the arms. I just go slow.
4) Is it weird to have to remove the drains yourself or did you get a local dr to do this?
My husband did it. Dr. S showed him how when he removed one so my husband would know what to do. I probably could have done it myself.
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Thanks, this helps a lot! ps - i could not find more recent DIEP threads... Will look again.
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