Guest guest Posted May 4, 2004 Report Share Posted May 4, 2004 Terrifc!!! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2004 Report Share Posted May 4, 2004 > I'll provide occasional updates on my progress...and the paperchase. > For reference, as it varies from carrier to carrier. I'm covered > under a CIGNA PPO. Excellent news, Alan. For what it's worth, I have a CIGNA PPO and they provided partial coverage for the resurface (everything except the cost of the Conserve Plus device itself). CIGNA is a real pain to deal with, but I'm sure it'll turn out all right in the end. Steve (bilateral C+ 4/20/04, Amstutz) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2004 Report Share Posted May 4, 2004 >> Excellent news, Alan. For what it's worth, I have a CIGNA PPO and they > provided partial coverage for the resurface (everything except the > cost of the Conserve Plus device itself). CIGNA is a real pain to deal > with, but I'm sure it'll turn out all right in the end. > > Steve (bilateral C+ 4/20/04, Amstutz) Steve, My dealings w/ CIGNA in four years of coverage have been minimal, and not entirely off-putting. But Nikki said it could take 30 to 60 days to get a first-response from. Wondering here...how long from the time you saw Dr. Amstutz the first time 'til CIGNA finally signed off on the coverage it did provide. (I'd really like to be back on the handball court on New Year's day...but with this schedule, that's looking much less likely.) Also curious what your final cost might have been. (Send to redace address, if you'd rather not post.) Walkin' like Chester Good...but only temporarily... Alan...(hoping for Left C+, Amstutz; before the next ice age.) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2004 Report Share Posted May 4, 2004 > > Steve, > > My dealings w/ CIGNA in four years of coverage have been minimal, and > not entirely off-putting. But Nikki said it could take 30 to 60 days > to get a first-response from. Wondering here...how long from the > time you saw Dr. Amstutz the first time 'til CIGNA finally signed off > on the coverage it did provide. I live in Colorado. I didn't actually *see* Amstutz until the day before the surgery, although I'd spoken to him at length on several occasions. CIGNA kept me in suspense until the day I flew to LA for my my preop exam - and I only got a decision out of them by complaining to my employer's HR department and noting that I'd already paid $1000.00 up front to have blood drawn at my local blood bank and shipped to Orthopaedic Hospital and had purchased non-refundable plane tickets for the surgery. They beat up our CIGNA account manager until he finally leaned on the preapproval folks and got them to talk to JRI. CIGNA still hasn't processed the claim for the blood draw and shipment (it's been about 2 months). A coworker of mine had to have cardiac valve replacement surgery in February - they didn't approve her until the night before the operation (and this was a life-or-death situation). I'm not impressed with CIGNA. All I could think of throughout the process was " Dammit, I'm in the PPO - I paid *EXTRA* to be treated like crap. " Your mileage may vary. > (I'd really like to be back on the > handball court on New Year's day It could still happen - and if it isn't New Years, it'll be Groundhog Day. ....but with this schedule, that's > looking much less likely.) Also curious what your final cost might > have been. (Send to redace address, if you'd rather not post.) Well, I agreed to pay for the implants at $6050 each, so that would be $12100 for the pair. Orthopaedic Hospital required that I pay for them in advance before they would allow Amstutz to do the surgery. $13100, counting my as yet unreimbursed blood shipment. I assume CIGNA will take their own sweet time about that. With any luck, the FDA will approve in late June and you'll be home free. > > Walkin' like Chester Good...but only temporarily... I hear ya - I may be on crutches now, but I'm not limping! Steve (bilateral C+ 4/20/04, Amstutz) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2004 Report Share Posted May 4, 2004 ALAN, YOU'RE TOO DANG FUNNY! SOMETIME BEFORE THE NEXT ICE AGE!!! KEEP IN MIND, FROM WHAT I'M GATHERING, LOTSA HIPPIES ARE HAVING TO PAY OUT OF POCKET, SO IF ONE HAS ANY COVERAGE AT ALL, PERHAPS NOT A COMPLETE BAD THING! ) In surfacehippy , " Alan Ray " wrote: Excellent news, Alan. For what it's worth, I have a CIGNA PPO and they provided partial coverage for the resurface (everything except the cost of the Conserve Plus device itself). CIGNA is a real pain to deal with, but I'm sure it'll turn out all right in the end. Steve (bilateral C+ 4/20/04, Amstutz) Steve, My dealings w/ CIGNA in four years of coverage have been minimal, and not entirely off-putting. But Nikki said it could take 30 to 60 days to get a first-response from. Wondering here...how long from the time you saw Dr. Amstutz the first time 'til CIGNA finally signed off on the coverage it did provide. (I'd really like to be back on the handball court on New Year's day...but with this schedule, that's looking much less likely.) Also curious what your final cost might have been. (Send to redace address, if you'd rather not post.) Walkin' like Chester Good...but only temporarily... Alan...(hoping for Left C+, Amstutz; before the next ice age.) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 5, 2004 Report Share Posted May 5, 2004 Alan, Amustutz acknowledges that his surgical technique has improved since he performed my first resurfacing early in 1998. He's developed new tools to minimize the invasiveness, and angles the implant more vertically for better support. Recovery and rehab on the second hip this year was at least a week ahead of my first (and I was skydiving 8 weeks post op after my first.) Work those gluts, upper hamstrings and abductors hard pre-op and you'll be surprised how soon you're back on the handball court pain free. Given your high fitness level, I predict you'll return to the court 10 weeks post-op or less. Follow Aleks () progress to gauge how you'll do. He's one day post op and that slacker has only made it across ICU and back. Good luck on the insurance end. Dave > > > > > Steve, > > > > My dealings w/ CIGNA in four years of coverage have been minimal, and > > not entirely off-putting. But Nikki said it could take 30 to 60 days > > to get a first-response from. Wondering here...how long from the > > time you saw Dr. Amstutz the first time 'til CIGNA finally signed off > > on the coverage it did provide. > > I live in Colorado. I didn't actually *see* Amstutz until the day > before the surgery, although I'd spoken to him at length on several > occasions. CIGNA kept me in suspense until the day I flew to LA for my > my preop exam - and I only got a decision out of them by complaining > to my employer's HR department and noting that I'd already paid > $1000.00 up front to have blood drawn at my local blood bank and > shipped to Orthopaedic Hospital and had purchased non-refundable plane > tickets for the surgery. They beat up our CIGNA account manager until > he finally leaned on the preapproval folks and got them to talk to > JRI. CIGNA still hasn't processed the claim for the blood draw and > shipment (it's been about 2 months). > > A coworker of mine had to have cardiac valve replacement surgery in > February - they didn't approve her until the night before the > operation (and this was a life-or-death situation). > > I'm not impressed with CIGNA. All I could think of throughout the > process was " Dammit, I'm in the PPO - I paid *EXTRA* to be treated > like crap. " Your mileage may vary. > > > (I'd really like to be back on the > > handball court on New Year's day > > It could still happen - and if it isn't New Years, it'll be Groundhog Day. > > > ...but with this schedule, that's > > looking much less likely.) Also curious what your final cost might > > have been. (Send to redace address, if you'd rather not post.) > > Well, I agreed to pay for the implants at $6050 each, so that would be > $12100 for the pair. Orthopaedic Hospital required that I pay for them > in advance before they would allow Amstutz to do the surgery. $13100, > counting my as yet unreimbursed blood shipment. I assume CIGNA will > take their own sweet time about that. > > With any luck, the FDA will approve in late June and you'll be home free. > > > > > Walkin' like Chester Good...but only temporarily... > > I hear ya - I may be on crutches now, but I'm not limping! > > Steve (bilateral C+ 4/20/04, Amstutz) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 5, 2004 Report Share Posted May 5, 2004 Alan, Amustutz acknowledges that his surgical technique has improved since he performed my first resurfacing early in 1998. He's developed new tools to minimize the invasiveness, and angles the implant more vertically for better support. Recovery and rehab on the second hip this year was at least a week ahead of my first (and I was skydiving 8 weeks post op after my first.) Work those gluts, upper hamstrings and abductors hard pre-op and you'll be surprised how soon you're back on the handball court pain free. Given your high fitness level, I predict you'll return to the court 10 weeks post-op or less. Follow Aleks () progress to gauge how you'll do. He's one day post op and that slacker has only made it across ICU and back. Good luck on the insurance end. Dave > > > > > Steve, > > > > My dealings w/ CIGNA in four years of coverage have been minimal, and > > not entirely off-putting. But Nikki said it could take 30 to 60 days > > to get a first-response from. Wondering here...how long from the > > time you saw Dr. Amstutz the first time 'til CIGNA finally signed off > > on the coverage it did provide. > > I live in Colorado. I didn't actually *see* Amstutz until the day > before the surgery, although I'd spoken to him at length on several > occasions. CIGNA kept me in suspense until the day I flew to LA for my > my preop exam - and I only got a decision out of them by complaining > to my employer's HR department and noting that I'd already paid > $1000.00 up front to have blood drawn at my local blood bank and > shipped to Orthopaedic Hospital and had purchased non-refundable plane > tickets for the surgery. They beat up our CIGNA account manager until > he finally leaned on the preapproval folks and got them to talk to > JRI. CIGNA still hasn't processed the claim for the blood draw and > shipment (it's been about 2 months). > > A coworker of mine had to have cardiac valve replacement surgery in > February - they didn't approve her until the night before the > operation (and this was a life-or-death situation). > > I'm not impressed with CIGNA. All I could think of throughout the > process was " Dammit, I'm in the PPO - I paid *EXTRA* to be treated > like crap. " Your mileage may vary. > > > (I'd really like to be back on the > > handball court on New Year's day > > It could still happen - and if it isn't New Years, it'll be Groundhog Day. > > > ...but with this schedule, that's > > looking much less likely.) Also curious what your final cost might > > have been. (Send to redace address, if you'd rather not post.) > > Well, I agreed to pay for the implants at $6050 each, so that would be > $12100 for the pair. Orthopaedic Hospital required that I pay for them > in advance before they would allow Amstutz to do the surgery. $13100, > counting my as yet unreimbursed blood shipment. I assume CIGNA will > take their own sweet time about that. > > With any luck, the FDA will approve in late June and you'll be home free. > > > > > Walkin' like Chester Good...but only temporarily... > > I hear ya - I may be on crutches now, but I'm not limping! > > Steve (bilateral C+ 4/20/04, Amstutz) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 5, 2004 Report Share Posted May 5, 2004 Dave... The folks at JRI were actually a little surprised at the level of my conditioning. Even when I had to quit playing handball, I've kept to the weightroom schedule (four days a week), and added a third Stairmaster session. I figure... there must be a good reason professional athletes recover as fast as they do. I'll guess it's their conditioning. As for the insurance stuff, I'll find a way to get it done. And I can be one insistent/perisistent son of a bitch, if necessary. But for now, they've advised me to let them handle it, and I've heard that Nikki can be effective in these matters. In regard to the doc's expertise... they asked me which surgeon I'd prefer... and I have no doubt they're all very good. But, given the chance to choose, I'll pick the guy who's been doing the design, developing the theory and doing the practice as long as he has. He's got a firm grip, a firm grasp...and he's obviously open to change that improves his work, so he's open to new ideas. I'll let you know how the insurance paper chase progresses. Thanks for your help and encouragement. Alan Quote Link to comment Share on other sites More sharing options...
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