Televisit with Dr. Constantino tomorrow

[Isaiah_40_31]

@Brandy, I was told that they may not have their insurance set up even by the time of my surgery so I’d have to pay out of pocket for Dr. Hepworth’s surgical fee which will range from $5K-$7.5K then they’d give me a superbill to bill my insurance for reimbursement. I was actually relieved to hear the cost would be so low as I was expecting some astronomical number then realized the hospital, anesthesiologist, etc. will be covered by my insurance. I do understand that if you see an out of network doctor, your insurance may not be willing to pay for the other charges I mentioned, thus I hope the insurance issues get sorted out prior to your surgery.

[Brandy]

Yes, thus my concern. I highly doubt they will have the time and resources available for me to help guide me through this. I can almost guarantee my surgery date will not hold.

[Jules]

So sorry that it’s caused a problem for you @Brandy , I hope that you can get it sorted and have a new surgery date soon

[Isaiah_40_31]

@Brandy, Some months ago, @lilwider had to acquire a medical insurance advocate to help her fight her medical insurance denial of surgery w/ Dr. Costantino. In various discussions she shared her journey to appeal the denial in some detail. It took some months, but w/ the help of the advocate, her insurance overturned their denial, & she was able to have surgery w/ the doctor of her choice even though he was out of network. If you search @lilwider insurance appeal the links where she discusses her insurance appeal ordeal will come up. You can also PM her to ask for details if you think that would be helpful. Here are a couple of discussion links to get you started.

I'm asking for my eagle syndrome familys help

I think it makes sense to have a vascular surgeon there to make sure the veins are functioning. Removing the styloid doesn’t always do it. I needed the jugular vein to be ballooned. They went up my groin (like they might do for a heart patient). There were these 3 drs: ENT Vascular Anesthesia There was equipment and people (or a person?)just for monitoring nerves. It was a specially equipped surgery room for it. I had monitors placed in my mouth and around my head. Jugular ultra sound and M…

Update ....final appeal

Geeze- it’s been jumping though one hoop after next, doing everything my insurance wants me to. I am in my final external appeal trying to get my surgery when low and behold Jules from Dr. Costantino’s office calls me to tell me that insurance overturned their decision! I was in a little shock and don’t think it sunk in. I was telling him that I just spoke with my advocate a few hours prior- and then the other line beeps in it was my insurance. I told Jules I’d call him back. My advocate confirm…

[Chrickychricky]

If you have an out-of-network benefit that allows you to use it out of your state then his office doesn’t have to do anything. You pay his bill, they give you a superbill that you submit to your insurance for reimbursement. Of course you have to check to se if all the other people and places that will be involved are in or out of your network as well. My insurance company has something called an Access To Care form for when there isn’t anyone in network who can perform the treatment/surgery. The doctor’s office has to fill that one out. There is also something called a Gap Exception which is when you have to use an out of network doctor where the doctor agrees to accept the negotiated rate of your insurance company. I believe that is how Dr. Costantino’s office has been successful getting out of state insurance to pay. Again, that form would need to be filled out by the doctor’s office. Best of luck to you.

[Jules]

Thanks @Chrickychricky for that info

[lilwider]

I’m here forl you if you need me

[Brandy]

Thanks for the tip about speaking with Lillian. I have chatted with her multiple times. My only issue is my insurance company (based in Connecticut) is not large enough where they have advocates for their clients. I had already asked months ago. Unless, she hired a private advocate to help…

[lilwider]

No I used the advocate from the insurance, though I did tell them I had contacted a lawyer. I was in the process of starting to work with them but my insurance over turned their decision

[Makreto]

@Isaiah_40_31 - in my recent visit with Dr.Damrose. He discussed with me about the recent case he worked on pertaining to decompression and he mentioned that there seem to be a thin layer covering IJV which they identified during the surgery and removed it . Which resulted in decompression of IJV.

[Isaiah_40_31]

@Makreto - You already had your surgery?! If so, that’s really amazing! So quick after your initial consult. I’m really glad to know your IJV has been decompressed, & I hope your recovery goes along quickly! I’ve had you on my mind ever since we last talked & was hoping the office visit went well.

Do you know what the thin layer covering the IJV was? It would be good for you to get a copy of the surgery report to have for your records. You can get it either from Dr. Damrose’s ofc or from the location where the surgery was done.

[jsisto]

Did you get a catheter angiogram/venogram done before your surgery or just straight to decompression with Dr. C?

[vap]

HI,
I had CTA and CTV completed & then the week before surgery they ordered another MRI to be done. I have not had a catheter angio/veno.

[jsisto]

Did you already have surgery? How are you doing now?