I need bilateral ijv decompression revision surgery. I met with Dr Costantino who suggests I am in need of revision surgery, removing more of C1 and muscle which is still causing the compression.
Now the problem: his staff! I have gone back and forth with unprofessional emails regarding prior auth. Final email this staff person will not proceed with scheduling. This provider is “in network” easy prior auth. I have called ins directly and they gave authorization and reference number. My several previous surgeries were out of network providers and they were covered with no issues. This has all gave me a bad feeling about this practice. I have called my diagnosing neurologist and they are trying to work with them on my behalf.
Can somebody give feedback regarding Dr Costantino that this is worth it, or should I move on? Or recommendation on who I should see?
It’s sad that one person in Dr. Costantino’s staff has caused you to question whether or not it’s worth having surgery with him. It makes sense that when things are straight forward on your end & an office person is “creating mountains” when there are no “molehills” would cause you doubt you’re in the right place.
If things don’t smooth out w/ Dr. Costantino’s scheduler, you could try Dr. Liu. @harrisonboy recently posted a video where Dr. Liu was interviewed & spoke about his approach to IJV decompression. You might be interested in watching his segment of the program:
I hope others w/ experience w/ Dr. C’s staff will reply to your question, too.
I ran into a wall with Dr. Liu. He is now saying that the only way he will review my case and give me an opinion is if I have new CtA CtV to see where things are at now. It is almost impossible for.me to get testing and referrals. I have worn my neurologist out, so this may be a no yo for me.
@harrisonboy My PCP ordered the CTA/CTV I just had. Over the years, my PCP has ordered most of my imaging. I wonder if yours would be willing to submit it for insurance authorization if you let them know Dr. Liu is specifically asking for updated imaging before giving an opinion?
For mine, the order used CPT 70471 with venogram, and the protocol requested arterial and delayed venous phase imaging. That may be worth mentioning, because I was told by radiology that the venogram needed to be explicitly requested on the order.
It’s so bewildering that this staff member has the control over your surgery and won’t proceed with things! Personally, given your complicated case and the need for revision, I would stick with Dr Costantino otherwise you could have to do the rounds of testing with a new doctor, as @harrisonboy has said…
I’m UK so our health care system is different- is there a formal complaints procedure you could follow? Otherwise shout from the rooftops about how this staff member is treating you (while maintaining what a helpful doctor Dr Costantino is) on every media possible- post it on his YouTube video, if the practice has any social media platforms, comment on those, everywhere you can think of! Good luck!
@harrisonboy - You’ve come so far, try not to let this current hurdle set you back. Ask every doctor you’ve seen as a patient for a referral for the scan until one agrees to order it as @MGORNEAU mentioned & provide the CPT code as that could be very helpful in getting the scan ordered.
I’m so sorry for another blockade, but you’re still heading in the right direction! Praying that it’s easier than you expect to get the updated imaging.
Anybody have thoughts regarding dr lui vs dr Costantino. I have heard dr c is a great surgeon, and even the provider who performed my angioplasty said he would go to him. But I have to admit in our appt I didn’t have a great sense of comfort. Just clinical talk, not really pertaining to my personal case. And now with this office difficulty, it really has me questioning. So anybody with some positive stories would really help
@birdie1 - Dr. Liu has done less IJV decompression surgeries than Dr. Costantino, but I think the outcomes for those who’ve had surgeries he’s done have had good outcomes. Did you see this link to a video interview he did discussing how he does his IJV decompression surgeries?
Have you tried sending a message directly to dr c through the portal? My daughter asked him a question through the portal and he responded to her himself.
@birdie1 - It seems most doctors’ offices now have patient portals. Sometimes a patient has to ask to be sent the link for the portal for a given doctor (this happened to me w/ Dr. Hepworth’s ofc). I think getting a link so you can set up an acct on Dr. C’s patient portal & contacting him that way will get you further than just sending an email.
I agree, but there isn’t even a patient portal tab on his website. I am on all patient portals with my other providers. Possibly they are going to the hospital portal he works thru?? I need to do some direct phone calling, but just not up for the fight. If they send me to the person doing prior auth she is relentless
Keep your chin up! You’ve done such a good job of self advocation so far even if it hasn’t fully paid off yet. You shouldn’t need to talk to the person who’s “messing with you” in Dr. C’s ofc to get a portal link. The front desk receptionist should be able to give that to you.
