Under the knife again...

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OK, I've healed up enough the doc wants to do it again and fix it. He apparently wants to charge me more, I am very angry with him at the moment, and also at myself. I did not ask enough questions.

I got a letter from the insurance. It appears he billed them $96,500. They will pay ≈$67K, which is still 3X the going rate for a top surgeon. If they don't work it out (he assures me they will) I am liable for the remaining $30, again more than the going rate for SRS. And this guy wants me to pay yet more for the second surgery. I will pay it of course, unless it is too much. I do not want to be a "barbie doll", smooth on the outside and nothing on the inside. First the health, then the finances. I have already agreed that I will settle for a smaller cavity, but I don't like it much.

I don't think he liked them mailing me the information. In this case it gave me a little bit of power. I didn't see it at first, but after consideration it means he is more than a bit exposed to other options it gives me, which shall remain nameless but should be obvious.

Something I should mention, it sounds like I am miserable. I'm not, I am at peace, and I am finally where I've needed to be all my life. I am not looking forward to the pain, and this little episode is going though some life savings at an accelerated rate, being unemployed will do that too. I'm thinking of writing up a list of key questions (Keep It Short Silly) and publishing them eventually for someone who may find themselves in a similar place.

Part of my mistake is I felt rushed. I had the insurance that would pay for SRS, but it was a use it or loose it option. Doing something like this in a hurry is never good, but if I had do to it again I would spend a few more days on research and pick a doctor with a reputation.

Comments

Was your surgery in the USA?

Probably not, since insurance covered much of it.

One of the greatest problems in the US is that most surgeries and hospital stays have wildly differing costs, with no rhyme or reason to why. Most of that is covered under some type of insurance and people not "cost shopping" allow those costs to skyrocket. No one wants to get second-rate care, but much of the difference has nothing to do with quality or reliability.

Your surgery, at least in the USA, is generally a strictly elective procedure. I would not think that there should be such a difference from one doctor to another, though I'd have to admit it would be par for the course here.

Good luck on moving forward.

SuZie

Oh, it was,

And in a local city too. No travel costs (which are out of my pocket). Plano Texas. You will note I'm not mentioning my doctors name, since this is still a work in progress I'll hold some judgement back. I am really not looking forward to the pain, I've turned into a real baby lately.

The company I used to work for had insurance that covered SRS, and I had an 11 week severance package that included insurance. Now it is COBRA for me, since the insurance ran out 4 days ago.

What the Hell !!!

96,000 Dollars or Bhat? Geeze I got mine done in Bangkok for $12,000 including the plane and accommodations in 2007. Hope things work out for you.

G

Wendy Jean...

have you thought of getting a second opinion?? What about a lawyer to sue for malpractice?? I understand the cost in Montreal is considerably less but my information is nearly 3 years old - it is my third birthday tomorrow!!!! If you wish I can make an inquiry as to cost from my surgeon. My surgery was paid by our government health coverage out of our collective taxes.

Just PM me if you want any more info.

Ruth

May the sun always shine on your parade

Health first,

Finances later. That letter gives me a few options.

Definitely excessive

Around 20K would be a more mainstream rate for a couple of surgeons here in the northeast US.

I paid 21K for the surgery/hospital/travel in 2001 in US from one of the top surgeons at that time.

Dr Marci Lee Bowers

Teresa L.'s picture

is a transwomen who works in San Mateo now, but was in Trinidad CO. when i first came across her reference, it showed a list of prices, getting the full treatment, trachea, breast augment, etc, was less than $50k, now that info might have been old so not sure how out of line that cost is, but drs ALWAYS overcharge insurance, so they get paid as much as possible from them. if they already covered that much, i would think he shouldnt be asking for more, and on the second, it should be at MOST cost, no profit as he flubbed it the first time. Now no surgery has guarantees, etc, but still make it right.

HUGS, hope it comes out ok in the end hon

Terri

Teresa L.

Find costs elsewhere

elrodw's picture

and provide them to your doctor and insurance company. He's trying, obviously, to bilk insurance for far more than "reasonable and customary." The insurance company will have a LOT more clout than you, and if he tries to stick you for the difference above "reasonable and customary", he could be charged with insurance fraud. I had to do that with one of my mom's doctors years ago - he was bilking her insurance and leaving her huge bills. Some were obvious double-billing. I collected data, contacted his office with a request for refund and 'cease and desist', and let them know I'd contact the SD Attorney General's office relating to fraud if he didn't. He fought. I sent the information. He settled quickly rather than be indicted for fraud.

If you know "reasonable and customary" charges elsewhere, or can get a credible, defensible list, work with your insurance company, and please be prepared to go higher if necessary. The doc is trying to commit fraud at your expense.

Fingers crossed, prayers said, etc, for a successful resolution to this nonsense.

Hugs,

Imagination is more important than knowledge
A. Einstein