I had had some semi-confusing correspondence with Dr. Nakaji’s office prior to this, and I’m wondering how you all feel I should move forward? I received this email about 1.5-2 weeks ago and it’s in regard to scheduling a consultation. I already have an appointment with Dr. Hepworth in June, although I’d like a second opinion. Im wondering if I should try to get in contact with their gap specialist, attempt to get a venogram from someone local, work on the gap exception on my end, or just wait until my appointment with Dr. Hepworth to determine next steps? All of the above? Or just be patient and wait to hear back?
Thanks! For context, Dr. Nakaji reviewed my CTA scans and a woman named Nancy called and said I could set up a consultation and to expect a call from Dr. Mehta to schedule the venogram, but instead of receiving a call from Dr. Mehta, I received a call from a woman named Nicole from Dr. Nakaji’s office who said it was pretty unlikely that would happen and she wasn’t sure if Dr. Mehta took my insurance but that I’d need to set that up. This is a reply from a follow-up email I sent. Below her message:
Thank you for contacting us. If you decide to move forward with getting a venogram with Dr. Mehta and the imaging indicates the necessity of surgical intervention, and the insurance company approves a gap exception, then we would schedule you for an appointment to visit Dr. Nakaji. First we need to diagnostically confirm an indication for surgery and come to an agreement with your insurance company. I have forwarded your information to our GAP specialists, and we anticipate receiving further updates soon. In the interim, we are committed to expediting your treatment and do not wish to delay it due to insurance concerns. We encourage you to continue to explore alternative providers for care in the event that we are unable to obtain approval from your insurance.
I think you should contact the GAP specialist who’s dealing with your case to see if that person can update you as to where things stand with your insurance company.
Some of our members have had a very easy time getting an appointment w/ Dr. Nakaji but others, like you, seem to have to “go to battle” for one because of the office’s persnickety insurance rules. Other offices grant the consult but let the patients know up front the cost for the consult so they can be prepared to pay it at the time of the visit, in case insurance doesn’t.
At this time, Dr. Hepworth & Dr. Samji are not accepting insurance for their initial consults so whatever they charge is the patient’s responsibility to pay. I suppose that Dr. Nakaji’s ofc checks to make sure insurance will help pay the various charges is a nice service but annoying when it drags on.
Thanks @Isaiah_40_31 , I’ll definitely try that route. She actually didn’t give me the name or contact information of the GAP specialist, so I guess I need to reach back out to get that information. I don’t want to seem like an “annoying patient” and I also feel the need to get things going and advocate myself. I just hate feeling pushy and what not. That seems like a good way to go though. Do you think I should give it a few more weeks or reaching out within the next week would be okay?
You can be politely pushy, @Kit_Cat. Just keep your tone friendly & be understanding when excuses are made as to why you haven’t heard anything but still press for an expected timeframe by which you’ll know what your insurance co. has decided. Let whoever you talk to know that you’ll be following up periodically if you don’t hear anything in a timely manner. Unfortunately, being a bit pushy is often necessary to keep a busy medical office mindful that you exist & are in need of the doctor’s expertise to help with your illness recovery.
That sounds good. I think you said it well when you mentioned that it’s necessary to keep a busy medical office mindful that I exist . I recognize that they have a lot on their hands, but I’m also in need of treatment. I appreciate the advice and will give it a go. Thanks!
Nicole said that she doesn’t want to delay your treatment due to insurance concerns, so I think @Isaiah_40_31 's advice to get details & to try to contact the GAP people yourself seems fair enough… personally I wouldn’t try & get a venogram with someone local, as if they’re not experienced with this it might not be done how Dr Nakaji wants it to be done, or might not cover everything he needs…you’d think it would be a standard thing but we’ve had members who’ve had testing not done properly!
Hope you can get things sorted soon!
That makes sense @Jules regarding the venogram. That’d be unfortunate to get it done and then it not be correct or have everything it needs, etc.! That sounds good though - thanks! I’ll try reaching out today to see if I can make any progress.
Dr. Pereira at St. Michael’s Hospital in Toronto is an excellent vascular surgeon to whom you can self refer. You can contact Marilou Reyes to schedule a consultation: marilou.reyas@unityhealth.to
Post right styloidectomy Dr. Pereira found a blockage caused by the right styloidectomy. He did a dynamic CT venogram (pioneered by Dr. Pereira and only available at St. Michael’s Hospital) to diagnosis and then treat it via an angioplasty to open the vein which 8 months later is still holding. My CT venogram images show multiple pathways have been created to divert the blood flow around the blockage which may have been sufficient to avoid an angioplasty but I wasn’t taking any chances.
Im from Vancouver canada how long after styliodectomy did you get balloon angioplasty?? Its been 4 months since I got decompression. Currently waiting to see him its been 4 months since our consult
. I recognize that they have a lot on their hands, but I’m also in need of treatment. I appreciate the advice and will give it a go. Thanks!
