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Author Topic: [Medical] Don't know what to do about my tonsils...  (Read 2635 times)
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Knightshade Dragon
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« on: September 30, 2008, 01:22:28 PM »

So for roughly a month now I've had a really sore throat.  I went to the doc and she said my tonsils were inflamed.  We ran through a "Z-Pack" of antibiotics and I still felt like hell.  I went back and she said that they were now worse.  I ran through another set of antibiotics and still felt no better.  I went back to the doc and got a referral to an ENT.  He took one look at my tonsils and said they needed to come out immediately.  WELL....he sends info to my insurance company and they call back wanting to schedule it up, after they collect my $2000.00 deductible.  Uh...I have roughly $1000.00 in my health fund for the remainder of the year, but I can't seem to find anyone able to explain how that doesn't apply to this surgery.  They say that I'll owe $2000.00 up front, and then they'll cover everything at 90%.  Given that the surgery costs $2197.00 in total, I can't see how this is any different than not having insurance at all.  I also can't see how my wife's thyroid removal last year cost me $97 dollars, and this one costs 2k.  It doesn't make any sense.  Anyone have any experience with something like this?  My tonsils are almost touching and closing off my airway at times, so I can't really see this as an 'elective' surgery.  Obviously this isn't service connected, so I'm not sure the V.A. would cover this....I don't know what to do.  Help?
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« Reply #1 on: September 30, 2008, 01:46:18 PM »

Call your companies HR rep and talk to them about the coverage.  The insurance companies like to play games when it comes to something that they can sluff off as another specialty; they really seem to do this with the mouth/throat area since some they claim as dental.

call your HR rep and maybe they can help out with clarification the insurance company may be looking at it wrong.  In some cases the company themselves choose lower coverage for specific procedures, you may be in that loophole as well.
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« Reply #2 on: September 30, 2008, 02:08:50 PM »

Quote from: drifter on September 30, 2008, 01:46:18 PM

Call your companies HR rep and talk to them about the coverage.  The insurance companies like to play games when it comes to something that they can sluff off as another specialty; they really seem to do this with the mouth/throat area since some they claim as dental.

call your HR rep and maybe they can help out with clarification the insurance company may be looking at it wrong.  In some cases the company themselves choose lower coverage for specific procedures, you may be in that loophole as well.

*nod*  I'm waiting for him to come in.  Perhaps he'll know what to do.  I'm having trouble breathing or speaking - if they'd like me to remain an employee for much longer, he needs to come up with something.
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« Reply #3 on: September 30, 2008, 02:45:07 PM »

If they say they'll cover 90%, then what SHOULD happen is that you pay the 2k, and then get the surgery and put in your claim.

They would then send you a cheque (check for you 'mercans) for the $1800 ... however if the 2k is for your major work DEDUCTIBLE then I'd say this is a crock of shit and move to Canada.

I would think that your doctor could find a way to write up that it's critical surgery. Would an ER visit change this? you could claim difficulty breathing as your airway is closing up.

I personally wouldn't want my tonsils out. They've done an excellent job stopping some nasty infections from going any further. Can your doctor explain why your tonsils aren't getting better? Antibiotics will destroy good and bad alike, so perhaps this is viral and the medication is hampering your bodies ability to heal? Is there any chance of cancer or other factor that could explain this behaviour? (remove the U to read that south of the border).
« Last Edit: September 30, 2008, 02:48:40 PM by Purge » Logged

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« Reply #4 on: September 30, 2008, 03:38:58 PM »

The worlds a bitch KD. Its all money money. Im sorry to hear its coming down on you. I live under it all the time. That insurance...well hell any insurance...is not all that helpful.

Had mine out when I was 5 so I didn't have to handle all that...just ice cream smile
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« Reply #5 on: September 30, 2008, 03:49:48 PM »

Man, $2000 deductible sucks. frown
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« Reply #6 on: September 30, 2008, 04:19:18 PM »

Ron - are you sure that this isn't the policy of the ENT office?  Usually when you have to pay that much up front, you are fronting the money for the ENT office - and like the other post said, you will then get a check from the insurance company.  Also, is the ENT in your medical network?  We've had some issues with this - which caused a huge out of pocket amount up front.  Also something to keep in mind is that if its out of network, they like to collect the money up front, and when your insurance company says - "the negotiated rate for these type of surgery is $800" - then you are going to get a percentage of that as your reimbursement.
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« Reply #7 on: September 30, 2008, 04:38:45 PM »

Quote from: kratz on September 30, 2008, 03:49:48 PM

Man, $2000 deductible sucks. frown

Yeah, that's an unbelievable deductible...
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« Reply #8 on: September 30, 2008, 04:47:18 PM »

That sucks Ron.  I just had emergency surgery over the weekend and have NO IDEA how much my bill is going to be.  I assume that since they didn't ask me any financial questions and that my insurance is SUPPOSEDLY very good, I am pretty well covered, but I have zero understanding of such things.

Good luck.

gellar
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« Reply #9 on: September 30, 2008, 05:48:20 PM »

Quote from: Zero on September 30, 2008, 04:19:18 PM

Ron - are you sure that this isn't the policy of the ENT office?  Usually when you have to pay that much up front, you are fronting the money for the ENT office - and like the other post said, you will then get a check from the insurance company.  Also, is the ENT in your medical network?  We've had some issues with this - which caused a huge out of pocket amount up front.  Also something to keep in mind is that if its out of network, they like to collect the money up front, and when your insurance company says - "the negotiated rate for these type of surgery is $800" - then you are going to get a percentage of that as your reimbursement.

They are in network.  This is the same doc / O.R. that did my wife's thyroidectomy - admittedly a fairly similar procedure.  Her surgery?  $76.00 out of pocket cost.  I just can't understand why mine is so much higher...
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« Reply #10 on: September 30, 2008, 05:53:16 PM »

Quote from: Knightshade Dragon on September 30, 2008, 05:48:20 PM

Quote from: Zero on September 30, 2008, 04:19:18 PM

Ron - are you sure that this isn't the policy of the ENT office?  Usually when you have to pay that much up front, you are fronting the money for the ENT office - and like the other post said, you will then get a check from the insurance company.  Also, is the ENT in your medical network?  We've had some issues with this - which caused a huge out of pocket amount up front.  Also something to keep in mind is that if its out of network, they like to collect the money up front, and when your insurance company says - "the negotiated rate for these type of surgery is $800" - then you are going to get a percentage of that as your reimbursement.

They are in network.  This is the same doc / O.R. that did my wife's thyroidectomy - admittedly a fairly similar procedure.  Her surgery?  $76.00 out of pocket cost.  I just can't understand why mine is so much higher...

Hmm...then I don't know why there would be difference.  I hope you get some answer from the HR rep.
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« Reply #11 on: September 30, 2008, 08:15:35 PM »

So the HR guy says that it doesn't sound quite right and that I should open a ticket with our health advocate.  They'll negotiate on my behalf and help get everything settled for the lowest possible cost to me.  I've used them in the past for a ridiculous dental bill and it turned out perfect.  Guess I'll just go down that road again.
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« Reply #12 on: September 30, 2008, 08:16:36 PM »

What do you mean by a "$1,000 health fund"?  Do you have a flex spending plan with a $1,000 available?

In terms of your deductable, is it $2,000?  If so, then you're responsible for the first $2,000 of services before plan coverage kicks in.  On most health plans, doctor visits and ordinary labs are frequently subject to co-pays, which are not subject to the deductable limitation, but almost all surgical events require you to satisfy your deductable obligation before coverage kicks in.  Explore w/ your ENT if he'd work with you on a payment plan if you don't have the 2K.  If you have $1,000 in flex spending, then you should be able to access that right after you receive treatment.

In terms of why your wife's procedure was treated differently, it seems like there are three options:  1. You had already met your deductable somehow last year, and hence her procedure was covered at 90%.  2. Your benefits changed from last year to this year; perhaps you didn't have a deducatble last year?  3. Your insurance company screwed up in your favor last year and forgot to require the deductable.  Hope that isn't the case, because they probably can still bill you for it if they discover the mistake.

Sorry to hear about your troubles.   frown
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« Reply #13 on: September 30, 2008, 08:21:21 PM »

Quote from: Eightball on September 30, 2008, 04:38:45 PM

Quote from: kratz on September 30, 2008, 03:49:48 PM

Man, $2000 deductible sucks. frown

Yeah, that's an unbelievable deductible...

Oh, one more thing, find out if that is a "family" deducatble or an individual deductable.  If it's a family deductable, then the individual deductable amount is probably much smaller.  On my plan, my family deductable is $2,250, but what that really means is that each member of my family has an individual $750 deductable that caps out at $2,250 (i.e., since there are four of us, if three of us met our deductables and the fourth one needed medical assistance, the fourth one's bills would be reimbursed at the percentage without having to meet any deductable amount, since the family cap of $2,250 would have already been met).
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« Reply #14 on: September 30, 2008, 09:07:30 PM »

Sorry to hear about your tonsils, Ron, but man, this thread makes me happy that I live in a country with free healthcare. I don't have to fear economic ruin just because I'm unlucky and get sick in some way.
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« Reply #15 on: September 30, 2008, 10:42:23 PM »

Just have your wife go in with a pair of scissors.  Nice and cheap!  icon_biggrin
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« Reply #16 on: October 01, 2008, 01:19:28 PM »

And if you're forced to pony up the $2k, tell the doctor. I don't know if this is everywhere, but when my hand surgeon was going over the cost of my surgery, she told me about how if you have insurance they charge about double or so more than if you don't have insurance.

Also something to consider is anesthesia. At the hospital I went to when I had hand surgery, they charge you for anesthesia separately. So I had a bill from the hand surgeon, a bill from the anesthesiologist, and a bill from the hospital.
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« Reply #17 on: October 01, 2008, 01:31:25 PM »

Quote from: Purge on September 30, 2008, 02:45:07 PM

I personally wouldn't want my tonsils out. They've done an excellent job stopping some nasty infections from going any further. Can your doctor explain why your tonsils aren't getting better? Antibiotics will destroy good and bad alike, so perhaps this is viral and the medication is hampering your bodies ability to heal? Is there any chance of cancer or other factor that could explain this behaviour? (remove the U to read that south of the border).

When I was a kid I was always getting sore throats. I had one stretch where I had three sore throats over the course of two months. I was getting over 5 sore throats a year. My tonsils were removed when I was 8 years old. Since then I have had zero throat infections. Zero. I also average about one cold a year. I'm assuming that my tonsils were defective and useless.
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« Reply #18 on: October 01, 2008, 01:47:43 PM »

Quote from: JayDee on October 01, 2008, 01:31:25 PM

Quote from: Purge on September 30, 2008, 02:45:07 PM

I personally wouldn't want my tonsils out. They've done an excellent job stopping some nasty infections from going any further. Can your doctor explain why your tonsils aren't getting better? Antibiotics will destroy good and bad alike, so perhaps this is viral and the medication is hampering your bodies ability to heal? Is there any chance of cancer or other factor that could explain this behaviour? (remove the U to read that south of the border).

When I was a kid I was always getting sore throats. I had one stretch where I had three sore throats over the course of two months. I was getting over 5 sore throats a year. My tonsils were removed when I was 8 years old. Since then I have had zero throat infections. Zero. I also average about one cold a year. I'm assuming that my tonsils were defective and useless.

Sounds like me. 2rd or 3rd grade I was out a lot due to my tonsils. Had them removed and now I'm almost never sick. Normally I just get sick when it goes from summer to winter or winter to summer (OK just has 2 seasons smile ) and then its just a mild sore throat.
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« Reply #19 on: October 01, 2008, 02:14:45 PM »

Ok, so I talked to my HR guy and he explained that our plan works backwards from most plans.  They provide a pool of $2000 that you draw from until it is exhausted.  They pay 90% of the bill out of that pool, you pay the 10% that is left over.  When that bill is exhausted, it goes one of two ways (this is the family plan thing mentioned above) - I have to meet a $2000.00 deductable personally, or have met a $3500.00 deductable as a family (The idea is that no one person would pay more than 2k).

As was pointed out, I need to actually worry about three bills - the doctor, the anestesiologist, and the hospital itself.  The surgery is a whopping 40 minutes, but I suspect they'll bill me $1000.00.  I could book a room at the presidential suite at the Bellagio in Vegas for that much.  Somehow I think my stay will be slightly less comfy than the Bellagio.   

Anyway - my HR guy pointed me to our Health Advocacy group.  Apparently they routinely turn $600 dollar Rx bills into bills for 100 bucks.  If anyone can negotiate on my behalf, apparently they are the guys to do it.  No wonder our healthcare system is a mess...
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« Reply #20 on: October 01, 2008, 02:25:19 PM »

I love Canada... even with wait times.

Required? Paid for. Insurance has a lot less to cover.
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« Reply #21 on: October 01, 2008, 03:03:45 PM »

Quote from: Purge on October 01, 2008, 02:25:19 PM

I love Canada... even with wait times.

Required? Paid for. Insurance has a lot less to cover.

Must...elect....Obama.....
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« Reply #22 on: October 01, 2008, 03:13:31 PM »

Quote from: Knightshade Dragon on October 01, 2008, 02:14:45 PM

Anyway - my HR guy pointed me to our Health Advocacy group.  Apparently they routinely turn $600 dollar Rx bills into bills for 100 bucks.  If anyone can negotiate on my behalf, apparently they are the guys to do it.  No wonder our healthcare system is a mess...

The primary purpose of an insurance company is to maximize ROI for their investors, which they achieve by denying payouts whenever possible. Many is the time that they have used the wear-him-down technique on me to deny covering legitimate bills.

They do, however, have some discretion.

I recently incurred a $135 charge for some chest xrays that my doc ordered. I wasn't expecting and couldn't pay that bill, so I called the insurance company's WTF Line. Turned out that I had not yet met my $250 deductible (I thought that I'd met it months ago). However, the young lady on the phone offered to "back it out" for me "as a courtesy." Whaaa? You can do that? Yup, they would cover the whole procedure, but I will still have to meet the remaining $135 of my deductible if I have any further charges this year. I just have to avoid medical care until my deductible resets in three months.

It sounds like you know a guy who knows a guy who can make the charge go away.
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« Reply #23 on: October 01, 2008, 03:21:22 PM »

Quote from: Knightshade Dragon on October 01, 2008, 03:03:45 PM

Quote from: Purge on October 01, 2008, 02:25:19 PM

I love Canada... even with wait times.

Required? Paid for. Insurance has a lot less to cover.

Must...elect....Obama.....
Then you'd get to suffer for months waiting for a surgery spot to open up.  Good times.
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« Reply #24 on: October 01, 2008, 03:25:08 PM »

In KDs situation? 4-10 hours (worst case) for ER/admission. This thread is what, 2 days old? He's been suffering for the last month.

Sure, if you're getting a hip or knee replacement you might be waiting for a bit. Something about doctors leaving the country to go work in the states in private practice.
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« Reply #25 on: October 01, 2008, 03:31:04 PM »

Quote from: Purge on October 01, 2008, 03:25:08 PM

In KDs situation? 4-10 hours (worst case) for ER/admission. This thread is what, 2 days old? He's been suffering for the last month.

Sure, if you're getting a hip or knee replacement you might be waiting for a bit. Something about doctors leaving the country to go work in the states in private practice.

Yeah but how *good* is the Dr who would be cutting on him?  All the good ones leave to get paid, yo slywink.

gellar
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« Reply #26 on: October 01, 2008, 03:44:27 PM »

Quote from: gellar on October 01, 2008, 03:31:04 PM

Quote from: Purge on October 01, 2008, 03:25:08 PM

In KDs situation? 4-10 hours (worst case) for ER/admission. This thread is what, 2 days old? He's been suffering for the last month.

Sure, if you're getting a hip or knee replacement you might be waiting for a bit. Something about doctors leaving the country to go work in the states in private practice.

Yeah but how *good* is the Dr who would be cutting on him?  All the good ones leave to get paid, yo slywink.

gellar

The doctor that did my wife's heart surgery actually came from the U.S. to Canada because as he put it, he was "tired of dealing with the financial aspect of doing surgeries." He just wanted to research and cut people up. He is also one of the best heart surgeons around and is known internationally. It's rare, but it does happen.

Oh, and the wait time for this "elective" surgery (she could have lived with the issue for a few years, so it wasn't "urgent")? Two weeks from the time she gave her "ok, let's do this."

Cost? $0

Our health care system may have its problems, but I'll take it over the U.S. system any day of the week.

But anyway, this thread is heading in a direction that KD didn't intend.
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« Reply #27 on: October 01, 2008, 03:46:09 PM »

Well, I'm working on convincing him to move to Canada.

Palin in power will be the trigger for the exodus. Tongue

Best of luck with the advocate man... you and Laura have had too much medical in your life as it is. I feel for you. frown
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« Reply #28 on: October 01, 2008, 05:51:15 PM »

Well, advocacy paperwork is sent off and I have a surgery date - October 24th.  I have training for the next two weeks, so I didn't want to interrupt that.  I'll go in at 6:00am on that Friday and try to rest over the weekend, possibly taking Monday as well.  Should be g2g after that.  I can't wait any longer than that I think.  This hurts and it's starting to constrict and affect my voice. 
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« Reply #29 on: October 01, 2008, 05:59:28 PM »

Quote from: Knightshade Dragon on October 01, 2008, 05:51:15 PM

Well, advocacy paperwork is sent off and I have a surgery date - October 24th.  I have training for the next two weeks, so I didn't want to interrupt that.  I'll go in at 6:00am on that Friday and try to rest over the weekend, possibly taking Monday as well.  Should be g2g after that.  I can't wait any longer than that I think.  This hurts and it's starting to constrict and affect my voice. 

Are you only giving yourself three days (Sat, Sun, Mon) to recover from tonsil surgery? I was out for a week as a kid and I've heard it's harder on adults. You may want to book more vacation.
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« Reply #30 on: October 01, 2008, 06:04:35 PM »

Quote from: JayDee on October 01, 2008, 05:59:28 PM

Quote from: Knightshade Dragon on October 01, 2008, 05:51:15 PM

Well, advocacy paperwork is sent off and I have a surgery date - October 24th.  I have training for the next two weeks, so I didn't want to interrupt that.  I'll go in at 6:00am on that Friday and try to rest over the weekend, possibly taking Monday as well.  Should be g2g after that.  I can't wait any longer than that I think.  This hurts and it's starting to constrict and affect my voice. 

Are you only giving yourself three days (Sat, Sun, Mon) to recover from tonsil surgery? I was out for a week as a kid and I've heard it's harder on adults. You may want to book more vacation.

Friday, Sat, Sun, Monday.   My surgery is at 6:00am.  It's not optimal, but I don't have a ton of vacation time left this year. 
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« Reply #31 on: October 01, 2008, 07:43:57 PM »

Does this mean we won't hear you sing at the fabulous Pete Rock Rock Band 2 Party in honor of Kato?
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« Reply #32 on: October 01, 2008, 08:19:07 PM »

Quote from: Harkonis on October 01, 2008, 07:43:57 PM

Does this mean we won't hear you sing at the fabulous Pete Rock Rock Band 2 Party in honor of Kato?

I'll have to stick to drums and guitar/bass.  I did purposely schedule around the party though. smile
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« Reply #33 on: October 01, 2008, 08:42:13 PM »

Unfortunately all the posturing means nothing.

KD's company chose the insurance plan they have and set the premium/deductable with choices they made.  Does it suck for him that he has to pay that much because of their choice?  Sure it does but blaming the system for what his company chose as coverage is missing the point.
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« Reply #34 on: October 01, 2008, 09:35:01 PM »

Quote from: drifter on October 01, 2008, 08:42:13 PM

Unfortunately all the posturing means nothing.

KD's company chose the insurance plan they have and set the premium/deductable with choices they made.  Does it suck for him that he has to pay that much because of their choice?  Sure it does but blaming the system for what his company chose as coverage is missing the point.

Talking with the Health Advocate today, that doesn't actually sound like the case.  It sounds like this can be settled for far less than the negotiated rate.   
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« Reply #35 on: October 01, 2008, 10:30:08 PM »

Good.
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