Author Topic: Anyone have Ins. issues with SBI?  (Read 23722 times)

ppearl214

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Re: Anyone have Ins. issues with SBI?
« Reply #30 on: February 28, 2010, 09:28:23 am »
Do you guys think it's OK to call MEI and ask them which Dr. does the most AN surgeries with the least complications, or the best success?  Just how would I word that ?

Sue, first and foremost... my condolences to you, your husband and family for your loss. My thoughts, prayers and wishes are with you all.

As to your question above... "In a New York minute" (ie; pretty darn quick) I would ask... and how to ask? Just as you noted in your question here.  Which dr's have done the most AN surgeries and please advise success rates, what complications their AN patients have run into post surgery and can you speak to any of their AN post-surgical patients for patient to patient reference?

Phyl
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

ppearl214

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Re: Anyone have Ins. issues with SBI?
« Reply #31 on: February 28, 2010, 09:29:47 am »
Point well taken,  thanks Phyl.
Mei Mei

no biggie, Mei Mei :)  Phyl
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

sues1953

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Re: Anyone have Ins. issues with SBI?
« Reply #32 on: February 28, 2010, 09:36:00 am »
Thanks Phyl,  I'll do it  ;D...........Sue
3.2 cm AN Right side diagnosed 12/4/09
Translab surgery May 2010 with Dr. Jack Kartush and Daniel Pieper at Michigan Ear Institute.
Successful surgery .5mm left on facial nerve.  Full facial movement. SSD, Tinnitis, tongue and lip numbness.  No headaches.  Back to living life.

ppearl214

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Re: Anyone have Ins. issues with SBI?
« Reply #33 on: February 28, 2010, 09:38:49 am »
Thanks Phyl,  I'll do it  ;D...........Sue

Hey Sue, do what you feel is best for you... I can only "suggest" and "not tell you" what to do...... my opinion is that by doing such, you will obtain add'l answers you seek.

Just my 2 cents.
Phyl
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

Denise S

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Re: Anyone have Ins. issues with SBI?
« Reply #34 on: February 28, 2010, 12:51:17 pm »
Sue, I am SO sorry to hear of your loss and your husbands feelings right now!!   I hope you are doing o.k. since I know your brain is already on major overload with this AN journey.   {Thinking of you often!!}

There is another new member on the forum that was asking about U of M and they are from Jackson, MI.   

Was wondering if you seen a dr. at MEI yet and if so who??     From what I remember Dr. Kartush was the #1 experienced there.   They work with the neurosurgeon Dr. Daniel Pieper from Michigan Head and Skull.  His bio on that website says he focuses on AN's a lot.  He does surgery and radiation.     My MEI doctor was Zappia and that is who I was referred to by my ENT.   I had spoke with one in Grand Rapids and Midland and chose MEI.   Honestly, I didn't do as much research ahead of time, but I felt comfortable where I was.    It is good that you have been on this site awhile before, but it also can be overwhelming due to all the information you can get.     

As for me, I knew due to the expense of the surgery, expense of travel, having kids ages 9 1/2 & 11, and knowing there were skilled doctors here in MI, plus knowing the #1 factor that I kept being told too was every situation is individual and where & how the tumor is plays the biggests factors,   I never had the thought of leaving the state.   


Hopefully when you make your calls and get some of the anwers you are looking for, your heart and mind will guide you in a comforting decision.

Take care,
Denise
W&W 2 yrs. (due to watching other brain tumor: it's stable)
Left AN:  1.2 cm (kept growing during 2 yr.)MIDDLE FOSSA  11/9/09;  Michigan Ear Institute Dr. Zappia & Pieper
SSD, mild tinnitus, delayed onset of facial paralysis lasting 3-4 weeks, no tears AN side
BAHA surgery 10/2/12 Dr Daniels G.R.,MI

marsha G

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Re: Anyone have Ins. issues with SBI?
« Reply #35 on: February 28, 2010, 11:05:39 pm »
I had my AN surgery by Dr. S at SBI on 12/15/10 and have had wonderful results so far.  I was only in the hospital 2 days and then stayed in a hotel for a week before flying home.  I have no facial problems or headaches. 

Insurance - I figured I would have to pay the maximum amount for year no matter where I went.  SBI negotiated with my insurance company to get the amount I would have to pay reduced.  They explained the difference in the days in the hospital and intensive care, etc. with the traditional surgery.  My hospital bill was $575.00 (I had a private room).  I have not gotten a final bill from SBI yet.  I was not required to pay anything up front.  They waived the initial consult fee when I scheduled my surgery.

Deciding what to do is the hardest thing.  I am very happy with my results.  I stayed at Thousand Oaks Surgical Hospital and it was wonderful.  The physical therapist that worked with me in the hospital and at my hotel for the week I was in California was great. I was back at work by Feb. 8 on light duty.

I will say that SBI is a very busy office so keep calling and insist on speaking with Roxie or whoever is handling your paperwork.  Sometimes it is the insurance company that delays things.  Call your insurance company and find out what the maximum you would have to pay in one year.  I decided it was worth it.  To save money both my husband and I used credit card miles to buy our airline tickets and also had enough for 2 days in the hotel and got lunch at the grocery store next to the hotel.
5mm x 5mm diagnosed 2/09 - watch & wait for 6 months
Lost additional hearing.  Endoscopic surgery 12/15/09, Dr. Hrayr Shahinian, Skull Base Institute.  No facial damage, reduction of noise in left ear, minimum balance issues

jerseygirl

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Re: Anyone have Ins. issues with SBI?
« Reply #36 on: March 01, 2010, 09:51:39 am »
Marsha,

This is great! It is quite a change from what I had to pay. My initial consult was $600 and the surgery cost me $20K out of pocket. Negotiating with insurance was a nightmare and I had to negotiate all other fees (anesthesiologist, pathologist, radiologist, genetic testing, etc.)  My hospital was also different: Brotman in Culver City. I have no idea how it compares to Thousand Oaks but  I stayed at NYU for my first surgery in 1988 and liked Brotman many times more.

SBI's ability and willingness to work with insurance companies certainly eases financial aspect of this surgery and makes it competitive to other places closer to home. I actually contacted some local neurosurgeons whose name never appeared on this board and they don't accept any insurance. The surgery would be much more expensive with them.

I am thrilled with your outcome. Continued wellness to you.

             Eve
Right side AN (6x3x3 cm) removed in 1988 by Drs. Benjamin & Cohen at NYU (16 hrs); nerves involved III - XII.
Regrowth at the brainstem 2.5 cm removed by Dr.Shahinian in 4 hrs at SBI (hopefully, this time forever); nerves involved IV - X with VIII missing. No facial or swallowing issues.

leapyrtwins

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Re: Anyone have Ins. issues with SBI?
« Reply #37 on: March 02, 2010, 08:06:50 am »
(Jan I PMed you last week did you get it  ???)

Sue in Michigan

Sue -

I did get your PM, just haven't had time to respond.  The weekend was kind of my children's birthday (no 29th in February this year - so the celebration lasted Saturday, Sunday, and part of Monday).  And I had issues getting onto the Forum - something to do with server problems.  Today's the first time I've been able to log on.

Will respond to your PM soon - hopefully this evening.

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

sues1953

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Re: Anyone have Ins. issues with SBI?
« Reply #38 on: March 02, 2010, 08:38:46 am »
Thank you all for your condolences concerning my father in law.  The funeral was beautiful.

Denise I saw Dr. LaRouere at MEI, I liked him OK, a little dry for my taste and not a wealth of information, although I did get pamphlets from the wall in the office.  I do have to say I had just been diagnosed and didn't have a lot of questions t that time.  I did call the office a few days later to try to get connected with past patients and I had absolutely no luck with that.  I have since talked to people here like you who have had surgery through MEI.  I had surgery scheduled for March 15th and just canceled it last week.  I was/am persuing Skull Base Institute in CA.  I am trying to get up the nerve to call the office and ask who of all the Dr's do the most AN's and has the best success.  I am a little afraid of how they will handle that question  ::)

Marsha, thanks for your success story about SBI.  I find it interesting that your cost seems different than I was just quoted last week.  They told you that your out of pocket would be no more than 20K?  They wouldn't tell me that at all.  It could be just the difference in our Insurance.  I have an HMO with no out of network coverage.  I am in the process of appealing that.  Roxy did suggest that I wait until open enrollment and change my insurance to a PPO but that's 8 months away  :(  Do you have a PPO now?  She also told me that the cost is generally 160K includes everything, barring no complications.  I am not putting a lot of hope in my insurance paying the whole thing.  I do have an out of pocket max of 1,000 but that's in network.  Even 20K is out of the question for us right now.

On a brighter note I made an appointment with Dr. Telian for March 9th for a second opinion.  I am excited to ask him all of my well rehearsed questions.   :) 

Sue in Michigan


3.2 cm AN Right side diagnosed 12/4/09
Translab surgery May 2010 with Dr. Jack Kartush and Daniel Pieper at Michigan Ear Institute.
Successful surgery .5mm left on facial nerve.  Full facial movement. SSD, Tinnitis, tongue and lip numbness.  No headaches.  Back to living life.