Author Topic: Monday....  (Read 2193 times)

carmen g

  • New Member
  • *
  • Posts: 21
Monday....
« on: March 19, 2007, 12:53:17 pm »
Hi everyone,

Well, it has definitley been a Monday.  I set up my appt in Denver with Dr. Muckle for April 3.  I have been referred to him by my local ENT.  I am in Wyoming, where we don't have the specialty docs.  Anyway, to get on with my story...

They called from Dr. Muckle's office and told me my insurance wouldn't cover me as the doc office was not in the "network".  I about had a panic attack.  Upon some research and talking to my local insurance gal, I was told that I am under an indemnity plan and do not have to stay in the network... Whewwww....  I suppose some of the charges may not fall in the "usual and customary" category and may not be covered, but the majority should be and I can appeal those charges.

Well, I am breathing a little easier now.  I am on a catastrophic policy, so I will have some medical bills, but will be able to manage those, probably about $3500 plus whatever is out of the usual and customary.  It is pretty ironic, I had just gotten back on my feet after a divorce, then this...  I am sure things will be fine though, just another bump in the road of life.

Carmen
Diagnosis received 3-9-07.
1.7 cm, left side
Retro-sigmoid surgery 5-23-07
No complications, recovering well

Jim Scott

  • Hero Member
  • *****
  • Posts: 7241
  • 1943-2020 Please keep Jim's family in your hearts
Re: Monday....
« Reply #1 on: March 19, 2007, 01:34:38 pm »
carmen g:

Glad to read that your insurance will cover the majority of your AN-related expenses.  FYI: most doctors and hospitals will accept whatever the insurance company agrees to pay but in some cases, they may require you to pay any balances left after the insurance payment.  It depends.  Most hospitals and medical practices will accept a 'time payment plan'.  You agree to pay off your bill within 12 months and they'll accept a monthly payment.  I did this with the MRI center, the anesthesiologist and the hospital where I had my surgery.  It wasn't a big deal...they all readily agreed.  I've paid off all but a few hundred on the hospital bill and that'll be done by summer.  As you so accurately stated: "just another bump in the road of life".  So it is.  :)
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

goinbatty

  • Sr. Member
  • ****
  • Posts: 288
Re: Monday....
« Reply #2 on: March 20, 2007, 05:13:57 am »
Some insurance plans have 3 benefit levels - in network, out of network, and out of area meaning no specialist or appropriate facility within a 50 mile radius. 
Glad to hear you're covered. 
1/2007 - 6 x 4.5 mm AN
8/2007 - 9 x 6 mm
CK at Georgetown 1/7/08-1/11/08; Dr. Gagnon
3/2008 - 10 x 7 mm
7/2008 - 9 x 10 x 6 mm (NECROTIC CENTER!!!!!)
5/2009 - no change/stable
4/2010 - 10 x 7 x 6 mm; stable/no change
5/2011 - 10 x 7; stable/no change
6/2012 - 8.1 x 7 mm
4/2014 - stable/no change