@vcp02 I’ve consulted with Dr. Osborne twice but concluded I could not come up with money after going in circles with BCBS Illinois and getting nowhere. They refused to pre-auth and refused to pay in network benefits. They just paid about $25k for my right intraoral excision w/Dr. Patel in Portland in December but were only going to cover about $7k for Osborne. I’m an insurance adjuster so I was fully armed but couldn’t get anywhere. BCBS Illinois is staffed with particularly incompetent people. On my last call the person hung up on me when they couldn’t answer my question and I politely asked for a supervisor.
I’m now waiting to hear back from Dr. Hackman’s office. My preference would be Dr. Osborne because I’m in Oregon. If you know and are willing to share, I’d like to know what you were left with for your share of the cost. I’d like to avoid the frustration and phone calls with BCBS if I still can’t afford Osborne. My voice is affected and my employer will not accommodate me so there is urgency and financial pressure as a single person. I’ve exhausted FMLA so I could lose my job at any time.
My left side will be a revision because the styloid grew back after surgery in 2011 so I need an external excision at the skull base. Dr. Patel does not want to do it. I have a short lower jaw which Osborne said was a contributing factor and it will make it harder to access. Your story validates my 100% confidence in Dr. Osborne.
@Kiki67 - You & @vcp02 should discuss the financial details of her surgery via a PM. You can click on her screen name in this message & that will take you to a page where you can start a private discussion w/ her.
I’m really sorry your medical insurance is being so difficult to deal with. That’s got to be immensely frustrating!
@Isaiah_40_31 Glad to take it to PM, thank you. It’s been particularly frustrating when finding treatment and dealing with insurance needs to be done by phone and I have limited ability to use the phone.
The level of incompetence is absolutely unreal. I don’t understand why the “little” people are working so hard to stop innocent people from adequate healthcare when the only ones to benefit are the billionaire CEOS. Entirely a broken system, I’m sorry for your exhausted efforts and understand your struggle.
I am willing to share and will take Wendy’s advice as suggested on a private message. However, I still don’t know… I do plan on updating that process but a side from the “approval” it will take another 39-90 days before they respond to the claim Osborne has submitted. I do know I will still be required to pay the difference of Osbornes cost but cannot truly estimate that. Best guess ~ 10k.
I know the numbers for theses procedures are absolutely extreme but I’m curious if something like “care credit” can help someone in this situation. Its a “lower” interest credit card for soley medical expenses.
Dr Osborne told me he had a pt going to see him for her 3rd sx. Both surgeons prior had failed to remove it at the base of the skull which he stated was crucial to prevent regrowth. I will keep you updated the second I get anything from them.
“” its called PPO waiver request"… other places call it " out of network exemption"
A Blue Cross Blue Shield (BCBS) out-of-network waiver allows members to receive care from providers not contracted with their health insurance network, potentially at a lower out-of-pocket cost than if they went out-of-network without a waiver. These waivers are typically granted when in-network options are unavailable or inadequate for a member’s specific needs.
Waivers may be granted when:
There are no in-network providers available in the member’s area.
The member needs specialized care not available within the network.
The member is unable to safely transfer to an in-network provider.
The member has unique needs, such as language barriers or specific medical requirements.
We have a program called WITT that’s mentioned on our home page that’s designed for people who can’t afford to pay their bill completely or who need help around the house, someone to pick up groceries, walk the dog, provide a ride to a doctor’s appt., etc. The program allows an individual to create a list of help (including financial) needed & then to submit that list to friends, relatives, coworkers, etc. @Kiki67 & @Trisha, if your insurance doesn’t come through, WITT might be helpful for you to at least look into.
