ANA Discussion Forum

Post-Treatment => Facial Issues => Topic started by: Pembo on April 28, 2011, 08:23:39 am

Title: Jackie Diels Cost
Post by: Pembo on April 28, 2011, 08:23:39 am

I found out today that she is considered out of network for my insurance. Does anyone have an estimate of the charges for a 2.5 day visit with her? Thanks.

Title: Re: Jackie Diels Cost
Post by: saralynn143 on April 28, 2011, 09:13:10 am

Sorry to hear that, Pembo. Does that mean they won't pay at all, or will pay at a lower rate?

At any rate Jackie's office should be able to give you information about cost.

Sara

Title: Re: Jackie Diels Cost
Post by: Cheryl R on April 28, 2011, 10:21:26 am

Debbi would and know others have been to her.      I did in 1992 for just a half day session and can't remember what it was but I had to be pre approved.      Can you appeal and say there is no facial therapist in network.       Would Todd be in network?     I bet Jackie could give you some ideas about how to get approved.           Also need to make sure they understand it is not cosmetic.
                                          Good luck with this.               Cheryl R

Title: Re: Jackie Diels Cost
Post by: Pembo on April 28, 2011, 04:21:09 pm

Thanks sara and cheryl. She is definitely out of network for me and my therapy benefit is only $2000 so costs are high. I have found another option I'm looking into. Keeping the faith

Title: Re: Jackie Diels Cost
Post by: mandy721 on April 29, 2011, 10:31:11 pm

Pembo,

I called the UW Med Center and they sent me an estimate of what the fees are.  I will check tomorrow to see if I still have the letter.  If i can't find it, I will post the information about getting the cost estimate.

Is there any way you can ask for a geographic waiver with your insurance carrier?  A number of Ken's doctor's are out of network, but there are no other specialists of their kind located within 30 miles.  Based on this, after requesting the waiver prior to service their charges are reimbursed at the in-network rate. 

 Miranda

Title: Re: Jackie Diels Cost
Post by: Debbi on April 30, 2011, 07:23:10 am

Hi Pembo,

When I initially contacted UW regarding the rates for facial OT, they quoted me somewhere around $500 per hour.  When I checked w/my insurance company, they did not cover Jackie or UW Hospital/Health Clinics.  Because I really wanted to give myself the best possible chance for success, I decided to go ahead and my husband and I found a way to finance it.  Much to my surprise, my insurance DID cover it - they covered it as Outpatient Occupational Therapy, which meant that it was covered at 90%.  Here is a bit I copied from the intial confirmation letter from UW:

Services are billed as “outpatient occupational therapy”.
The five-digit commercial codes for the facial retraining therapy services are:
facial evaluation (97003) and neuromuscular retraining (97112).
The UW Hospital and Clinics provider federal tax ID# is 391835630.
Current UW Hospital and Clinics' therapy charges can be obtained by calling the UW Priceline at 608-263-1507.
 

I would suggest that you check your insurance plan to understand how they cover Outpatient OT, as this was the difference for me of it being covered.  Feel free to PM me if you want any other info about my visit to Jackie.

Good luck!
Debbi