NOLA in September?

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  • MartyJ
    MartyJ Member Posts: 1,859
    edited May 2013

    Maggie - just don't expect much of TSA.  Offer to touch the drain bulbs so they can scan your hands.  That can help.  Just remember that it is better for them to check carefully than for a bad person to get by with forged documents.

    Coding can be crazy.  I got a call about 2 weeks ago from the local hospital for $7,000 for the nuclear stress test the Cardiologist had to do prior to surgery.  He couldn't do any other stress test because the old implants blocked the signals.  I told the hospital that they really needed to check carefully as the tests must have been miscoded when submitted to insurance as they were essential medical evaluation.  Still waiting, but not stressing.

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  • LAstar
    LAstar Member Posts: 1,574
    edited May 2013

    Maggie -- so glad you got the neck drain out!  That sounded so painful!

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  • Cherrie
    Cherrie Member Posts: 1,423
    edited May 2013

    Dr. M actually told me she likes to keep patients on schedule at 3/4 mo. apart. My stage 2 was 3.5 mo. Later and I had no complications. My 2b was scar revision and 2c in the fall will be final fat grafting. So, there will be 7 mo. between my lipo and fat grafting. No complications except for drain site taking its time to close. It finally has.



    I need to be done for insurance reasons also. I met deductible last year and this year. That is enough!

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  • bdavis
    bdavis Member Posts: 6,201
    edited May 2013

    I had no real insurance problems with stage I, Ib and II... I think in all of that, maybe 14K wasn't covered.. That was in 2011. The Center/SCSH just absorbed it. But my stage IIb is another story. Vickie said that the more surgery you have, the stingier they get with pay out. I think they covered a lot of Dr D's bill, but the hospital bill not so much. Of the 110K billed, I think they paid 30K, so explanation of benefits says I owe 79k or something... plus another 6k for Dr D... Anyway, I called Vickie who said that the first round of submittals are read by computers, so lipo is generally denied. Then they appeal and it usually gets paid. I offered to get involved, but they said it wasn't necessary... of course, that day may still come. It also made me nervous cause I now have a stage IIc in November - I have hotel, plane tickets and expectations. So it better all work out. I do trust it will... I haven't done anything absurd. I did question Aetna about one denial and they said that collegen was used as a filler and that wasn't specifically mentioned in my pre-authorization.

    As for timing between stage I and II... many women need to get surgeries in in a timely manner due to insurance. So they say at least 3 months. But waiting longer is always better if you can do it. I had my stage II 3 months post DIEP (4 months post GAP), and I was still pretty swollen. So in retrospect waiting would have been best. So I waited 14 months until my stage IIb, and will wait 10 months to IIc.

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  • Barbmal5
    Barbmal5 Member Posts: 92
    edited May 2013

    Hello everyone. Still celebrating from Wednesdays post-op. Dr D pulled 3 drains & I did a happy dance for the nurses. He also told me I could wear an uncut bra as long as I watched it. Guessing "watch it" probably meant every couple of hours instead of at the end of the day after a city tour, shopping & concert at Lafayette park. Dummy me. Ended up developing & bursting a blister on the side of the right nipple. Center told me to put on neosporin & keep it covered? Thought I would need to dry it up & go back to cutting holes. Confused but much more watchful now.



    As far as waiting for stage 2. I'm scheduled Aug 14, exactly 12 weeks after stage 1 & specifically asked Dr D because of all the talk. He said, like others have said, 12 wks is the minimum & each person is different. He felt because of the way I was responding so far that I'd be perfectly fine. I'm also one on a time budget with insurance & have things in place so i'll probably go ahead plus if I wait too long i'll never go back!



    Karen, you looked awesome yourself! Hope your flight was uneventful.

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  • Judy_63
    Judy_63 Member Posts: 247
    edited May 2013

    I'm having my stage two 12 wks after my first stage on June 17. I'm hoping this will be the last and onto tatoos in Sept. I'm wanting to get all this over with by the end of the year since I've met my out of pocket now and insurance pays 100 %. So far my insurance has paid Dr. Trahan and Dr. Stolier and the anesthesiologist. Still waiting for the hospital, Dr. Dellacroce and the PA Amy G. fees to be paid. They have filed, insurance is taking their time but I can understand why that's a lot of money to let go of.

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  • bdavis
    bdavis Member Posts: 6,201
    edited May 2013

    Oh.. Amy G was denied for me... Then they paid out like $500...

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  • bdavis
    bdavis Member Posts: 6,201
    edited May 2013

    Oops... just looked again at my Aetna website... Dr D was covered about 50%... That's when Vickie said they would keep appealing.

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  • ssla01
    ssla01 Member Posts: 480
    edited May 2013

    What a relief to see that you all are fighting insurance too. I am most stressed about that. I have a surgery date that is in June, but have not heard from Vicke in almost two weeks. Dr. Masseys office wants me to do pre-op stuff, stop meds, & complete travel arrangements, but I don't want to do any of it if this surgery isn't going to happen. I am starting to think it would just be easier to let the local surgeon do a lumpectomy.



    Sorry, vent over. Sharon

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  • Russell1
    Russell1 Member Posts: 421
    edited May 2013

    Thanks for all the feedback about time between stage 1 and 2:) I feel like all my swelling is gone. I hope it's all gone from my new breasts! I don't want them to get any smaller. My pre-masectomy bras mostly fit. Lefty is a little bigger than righty. Stage 2 should take care of it.

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  • bdavis
    bdavis Member Posts: 6,201
    edited May 2013

    Sharon... Go for it!!!

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  • ssla01
    ssla01 Member Posts: 480
    edited May 2013

    Bdavis - does " go for it " mean you recommend lumpectomy?

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  • Judy_63
    Judy_63 Member Posts: 247
    edited May 2013

    One time when I looked at my insurance claim page they had paid Amy G. fees and boy did they cut her way down from what she was charging and I guess someone wasn't happy with that amount and so now it's back to "in process".

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  • MartyJ
    MartyJ Member Posts: 1,859
    edited May 2013

    Sharon- I agree with Betsy. Just do it. Get the tests, make the travel plans, stop the meds. I received a direct denial before surgery due to lack of information. Called Dr. Massey's office and they got right on it. After Stage 1, I received an accident report form from insurance so they could go after the other guy's insurance. Apparently the removal of damaged implants uses an insurance code that is in a group that identify accidental injuries. Again, Dr. M's officed helped me with it.



    I am on a 16 week schedule. Stage 1 in November, 2a in April, 2b will be in August and 2c in December. Hoping for tattoos in April 2014 to ice the cake.

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  • Russell1
    Russell1 Member Posts: 421
    edited May 2013

    MartyJ..icing on the cake..love it!!! It truly is a process:)

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  • PinkHeart
    PinkHeart Member Posts: 1,193
    edited May 2013

    Ssla01,



    Is your insurance in network?



    Can hjhg

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  • LAstar
    LAstar Member Posts: 1,574
    edited May 2013

    I'm so excited to be hosting our NOLA sister, Eva Moon, tomorrow night for a local performance of her one-woman musical, "The Mutant Diaries: Unzipping My Genes."  It will be a hoot!  I'm glad to finally meet Eva!

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  • ssla01
    ssla01 Member Posts: 480
    edited May 2013

    Pinkheart- my insurance is not in network, but the insurance company granted an in network exception. So it seems to me that should take care of it. I haven't heard from te Hospitals insurance person again. I was so uninformed to believe that if I got the exception, it would all be easy. :-(

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  • bdavis
    bdavis Member Posts: 6,201
    edited May 2013

    Sharon.. to be honest, no one or not many are in network, so you are fortunate. Mine is out of network but is managed by a third party THREE RIVERS.  I think in general it works out, but the path to get there can be rocky. The gals in NOLA are excellent at getting paid.

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  • mags20487
    mags20487 Member Posts: 1,591
    edited May 2013

    I have not received any amount due bills from any of my 3 stays at st charles and they total over $400G billed. My insurance payments have been horrible and I worry that they are coming to get me. It is not fair that we must worry about the financial stuff.



    Got a date for stage 2a! August 19th in Charleston! Perfect boobies here I come



    Maggie 2

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  • MartyJ
    MartyJ Member Posts: 1,859
    edited May 2013

    Maggie - let me know what info I can share about Charleston. My Stage 2n is on Aug 6.

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  • MartyJ
    MartyJ Member Posts: 1,859
    edited May 2013

    Oops. That's 2B. I am not up to N and hope never to be.

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  • Catie2013
    Catie2013 Member Posts: 1,023
    edited May 2013

    LOL Marty - was doing the math and you'd be hard pressed to get up to N already!!!!

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  • mags20487
    mags20487 Member Posts: 1,591
    edited May 2013

    marty---hahaha.  I hope no one gets up to N.  Thanks I may hit you up for that info

    Maggie

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  • Russell1
    Russell1 Member Posts: 421
    edited May 2013

    NO Stage 2N's ! lol

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  • Pamela44
    Pamela44 Member Posts: 143
    edited May 2013

    I went for stage 2, 12 weeks to the day after stage 1. All went well, no problems. I couldn't wait for it to all get finished.

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  • bdavis
    bdavis Member Posts: 6,201
    edited May 2013

    Pretty sure there'd be insurance issues with stage 2n

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  • Catie2013
    Catie2013 Member Posts: 1,023
    edited May 2013

    Maybe 2 n = two nipples?

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  • Pattysmiles
    Pattysmiles Member Posts: 954
    edited May 2013

    Is 2n when they do a recall because insurance hasn't paid?

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  • Catie2013
    Catie2013 Member Posts: 1,023
    edited May 2013

    LOL Patty!



    Or 2n = 2 NICE!

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