Author Topic: Kaiser Out of Network  (Read 1037 times)

mariab

  • Newbie
  • *
  • Posts: 1
Kaiser Out of Network
« on: April 30, 2018, 11:47:40 am »
Hi,

I was recently diagnosed with AN through Kaiser. After various consults within Kaiser and outside of Kaiser, it is recommended that I have surgery to remove it. It was recommended that I have surgery done in the next two months.

I do not want to go through Kaiser. Kaiser was very scary and told me that there is a 50% chance of me losing my hearing if I go through surgery. The Dr. made it sound like decisions such as how much of the tumor to remove would have to be done during the surgery or as the Dr. said: "it's a game-time decision."

I have read a lot and consulted with various providers outside Kaiser and found that I would like Dr. Friedman and Dr, Schwartz at UCSD to be my surgeons. They are highly experienced in AN.

Has anyone been able to get out of Kaiser and have them approve out of network surgery? If so can you share your process?

CHD63

  • Administrator
  • Hero Member
  • *****
  • Posts: 3207
  • Life is good again!!
Re: Kaiser Out of Network
« Reply #1 on: May 01, 2018, 07:00:35 am »
Hi mariab .....

Try calling Kris Siwek, the patient navigator at UCSD Head and Neck Surgery Center.  (858)657-5376  She would be able to either help you or direct you to the right people.  See:  https://health.ucsd.edu/specialties/surgery/otolaryngology/areas-expertise/acoustic-neuroma/Pages/resources.aspx

Best wishes on working through the insurance maze.  Drs. Friedman and Schwartz are awesome!

Clarice
Right MVD for trigeminal neuralgia, 1994, Pittsburgh, PA
Left retrosigmoid 2.6 cm AN removal, February, 2008, Duke U
Tumor regrew to 1.3 cm in February, 2011
Translab AN removal, May, 2011 at HEI, Friedman & Schwartz
Oticon Ponto Pro abutment implant at same time; processor added August, 2011

sg_way

  • New Member
  • *
  • Posts: 5
Re: Kaiser Out of Network
« Reply #2 on: June 30, 2018, 11:52:16 pm »
Hi mariab,

I'm with Kaiser and looking for out of network solution too, just wondering if you have any progress on this?


Thanks,
wayn

mspeer52

  • Newbie
  • *
  • Posts: 2
Re: Kaiser Out of Network
« Reply #3 on: October 29, 2018, 04:50:14 pm »
Mariab

I am a Kaiser member in Denver Colorado. What city/town are you in and did you have any luck obtaining a referral? If you have had success with Kaiser, who was your main contact there? I am considering UCSD (Friedman & Schwartz).

Thanks!

Michael

sg_way

  • New Member
  • *
  • Posts: 5
Re: Kaiser Out of Network
« Reply #4 on: October 29, 2018, 05:52:20 pm »
Hi Michael,

I've talked with Dr. Friedman couple months ago and he told me that Kaiser doesn't make out of network referral in AN case (I live in Los Angeles). I believe many in this forum recommended Dr. Cueva and Dr. Mastrodimos in Kaiser San Diego, Dr. Cueva and Dr. Friedman have a fellowship in UCSD and he has done about 900 AN surgery with Dr.Mastrodimos in their 25+ years practice. I would suggest you to contact them if you're a Kaiser member, they will perform my surgery soon.


Wayne

mspeer52

  • Newbie
  • *
  • Posts: 2
Re: Kaiser Out of Network
« Reply #5 on: November 12, 2018, 03:47:30 pm »
Thanks, Wayne.

I'll check into the 2 docs that you suggested.

Michael

 


anything