Questions

Tsimitpo

Hello, first post on this site. I am scheduled for scar tissue removal at the end of this month. Has anyone had this procedure, how did it work out for you?

Hopefully I have a successful outcome and can go on to have an AUS fitted at last. Incontinence is a huge problem for me.

As regards the AUS, can anyone recommend a surgeon/ clinic for treatment? I am not restricted by area. Also I will be paying out of pocket, no ins., I have heard anywhere from 18 to 30 grand. Seems a big discrepancy anyone have the facts on this?

i thank you in adavance.

Grinder

negotiate for discount

I cant help you with your scar tissue question, but the wide disparity in medical costs is a common phenomena. Besides our insurance we had with Anthem, I also subscribe with Christian Healthcare Ministries... Since CHM is not insurance, you do not get the discounted rate the insurance companies get, so they encourage you to negotiate with the hospital to get the discounted rate. You can see the wide range of costs for my Davinci procedure...

The hospital bill was over $55,000!

The final negotiated cost to my insurance company was $21,300! Thats a difference of $34,000!

Our copay was some $2,000, since our deuctible for that year had been covered long before this operation.

That's another thing that should be mentioned... if anybody is planning multiple procedures, like the biopsy, MRIs, RP, etc. you may want to get it in a single year like I did, including a colonoscopy, an endoscopy, and some visits to the ER... Our deductible is $5,000, so it was wise to crowd it into the same year's deductible.

Anyway... the cost for out-of-pocket procedures have to be negotiated. The disparity is enormous.

And if anyone is on the Obamacare exchanges... well, good luck with that.

Tsimitpo

Questions

Thank you grinder, scary numbers.

lighterwood67

Grinder said:

negotiate for discount

I cant help you with your scar tissue question, but the wide disparity in medical costs is a common phenomena. Besides our insurance we had with Anthem, I also subscribe with Christian Healthcare Ministries... Since CHM is not insurance, you do not get the discounted rate the insurance companies get, so they encourage you to negotiate with the hospital to get the discounted rate. You can see the wide range of costs for my Davinci procedure...

The hospital bill was over $55,000!

The final negotiated cost to my insurance company was $21,300! Thats a difference of $34,000!

Our copay was some $2,000, since our deuctible for that year had been covered long before this operation.

That's another thing that should be mentioned... if anybody is planning multiple procedures, like the biopsy, MRIs, RP, etc. you may want to get it in a single year like I did, including a colonoscopy, an endoscopy, and some visits to the ER... Our deductible is $5,000, so it was wise to crowd it into the same year's deductible.

Anyway... the cost for out-of-pocket procedures have to be negotiated. The disparity is enormous.

And if anyone is on the Obamacare exchanges... well, good luck with that.

Explanation of Benefits

Well, this was must first major surgery in 59 years.  And my first since becoming 65 and falling under Medicare.  Because I was in the military for 26 years my supplemental falls in with Tricare for Life.  So far, my claim summary says I may owe $23.00.  The amount billed was $88,877.41.  This will be a good test for Medicare and Tricare for Life.  A lot of the remark codes said "Medicare has applied the following cutback, discount, or other payment reduction to the claim".  It also said, "Neither the beneficiary, nor Tricare for Life is obligated to the amount billed".   I guess those 26 years of moving the family 15 times in 26 years and serving in 2 combat zones was worth it.  God Bless America.