Anyone out there have an effective way to navigate the in-network/out-of-network maze of insurance? Most hospitals have both in and out doctors working there. ...Read more
Anyone out there have an effective way to navigate the in-network/out-of-network maze of insurance? Most hospitals have both in and out doctors working there. With heart valve replacement surgery, I can only imagine the number of doctors involved. Is there a way to make sure all personnel are in-network given one likely won't know who get involved until after dismissal from the hospital and the bills start rolling in?
Marie Myers I think your only hope is to do this pre op . Once you are in the hospital, you are at the mercy of w ... Read more
Marie Myers I think your only hope is to do this pre op . Once you are in the hospital, you are at the mercy of whoever is on call or available.. The wider your network, the better chance everyone is in network. I was on the receiving end of a large anesthesia bill for a TEE when the anesthesia dept was not in network. This occurred in a narrow, low cost insurance network. Lesson learned!
Jim Musser Proof of the insanity of the insurance system! Thanks for the info. I appreciate it!
Catie B Jim, I hear your frustration. Even at in-network facilities, they can pull in an out-of-network radio ... Read more
Catie B Jim, I hear your frustration. Even at in-network facilities, they can pull in an out-of-network radiologist to read images or you get a visit from an out-of-network NP or something. As long as you choose an in-network facility, you're in position to discuss it with your insurer if something occurs that's beyond your control.
Barbara Wood I was in hospital for a cardioversion in Jan. We were concerned that the anesthesiologist might not b ... Read more
Barbara Wood I was in hospital for a cardioversion in Jan. We were concerned that the anesthesiologist might not be in network- we checked it out with a social worker who made all the necessary calls to the insurance company before we gave permission for the procedure. The insurance co. said it was basically all under one umbrella-this was at an in network hospital - so everything would be covered- and it was.
Jim Musser Marie, Catie, and Barbara, thanks for your input! It's very helpful.
I live in a small town in NC and am looking for a reputable cardiovascular surgeon in the state from whom to get a second opinion. My local cardiologist is ...Read more
I live in a small town in NC and am looking for a reputable cardiovascular surgeon in the state from whom to get a second opinion. My local cardiologist is recommending a heart cath to determine the exact measurement of my bi-cuspid aortic valve which he has concluded shows the stenosis as "critical." I am considering two Duke U. doctors (Donald Glower and Peter King) based on some research, but welcome other recommendations.
Shannon Gray I am in NC, too. I went to Duke for a few years before we moved, and they were wonderful. Where are y ... Read more
Shannon Gray I am in NC, too. I went to Duke for a few years before we moved, and they were wonderful. Where are you located within the state? East, mid, or western area? I can certainly share my experiences.
Jim Musser I live in Boone, Shannon, which is a fairly isolated mountain town. From what I was told by my local ... Read more
Jim Musser I live in Boone, Shannon, which is a fairly isolated mountain town. From what I was told by my local cardiologist's nurse, he wants to refer me to a surgeon in Winston-Salem, but I would like to consider more options.
Shannon Gray Absolutely! I would, too. Sanger Heart and Vascular in Charlotte has a wonderful congenital cardiolog ... Read more
Shannon Gray Absolutely! I would, too. Sanger Heart and Vascular in Charlotte has a wonderful congenital cardiologist, Dr. Alegria. I'm not aware of the surgeons as I had everything done at the Cleveland Clinic. The cardiologist at Duke were helpful, but the last time I went there was 5 years ago and I have not kept up todate on their latest. Wishing you the best, and please don't hesitate to ask any questions.
I'm in Wilmington nc, I had my mitral repair 12/7/15 at Duke by Dr. Glower, you will not find a more ... Read more
I'm in Wilmington nc, I had my mitral repair 12/7/15 at Duke by Dr. Glower, you will not find a more dedicated, talented or careing surgeon. He personaly checked on me everyday at Duke. š He is hands on for the entire journey. I did the heart cath and other tests in Wilmington and brought the results to Duke for the consult.
Jim Musser Thanks Greg for the info on Dr. Glower. And, Shannon, thanks for the info on the clinic in Charlotte ... Read more
Jim Musser Thanks Greg for the info on Dr. Glower. And, Shannon, thanks for the info on the clinic in Charlotte. How did your insurance treat you going to the CC, or were you an Ohio resident at the time?
Shannon Gray Our plan allowed for me to go to CC...very thankful.
Jim Musser Shannon, that's wonderful! How did you handle the post-op? My concern with going far away is the log ... Read more
Jim Musser Shannon, that's wonderful! How did you handle the post-op? My concern with going far away is the logistical challenges of follow-up visits, and, for my wife, a support system during the surgery and immediately afterwards.
Shannon Gray It went well and they have a concierge there who is amazing! Flying to CC was tough, but we certainly ... Read more
Shannon Gray It went well and they have a concierge there who is amazing! Flying to CC was tough, but we certainly racked up some airline miles. My husband and I flew ahead of time for preop, and then my parents and brother actually flew up for surgery. After you are released, they want you to stay close by for a few days until you go back in for a clearance appt. I am thankful for that as I had serious complications that put me back into the hospital for two,weeks...and it was the day before I was supposed to have my clearance appt.
throughout this year, my cardiologist there has been avaiable to answer questions through his nurse, and I also rely heavily on my dr here at home. I have gone back to the CC twice since surgery within a year, and now it's once. A year. Any questions, please ask away.