Not Taking Insurance......

Discuss here about Medical Disability claims and Insurance possibilities for PN treatment options
Post Reply
PN-SufferVT
Posts: 87
Joined: Fri Oct 22, 2010 8:46 pm

Not Taking Insurance......

Post by PN-SufferVT »

So I had some time today to read many of the post, especially of course the ones that might help my specific case. I have some issue with physicians being bad mouthed for not taking insurance. Ok, lets talk about this issue..... there is pure fee for service (no coding) and then there is pay up front and submit to insurance. I know that we all love to be "in Network" with the provider we want to see, but often we aren't, and often to get the best care we have to go out of network. Many of us say, well they are out of network, but they still bill my insurance....... so I will try them out.

My comment is WHAT is the difference in this and submitting it yourself. In 90% of the cases there isn't a whole lot of difference. The insurance is going to pay what they want to pay, yes you will not get preferred provider discount, but hey I would mortgage my house to get rid of this pain..... By profession I am a financial planner, by training I am an economist..... So how I look at it is this; What is the opportunity cost of staying in pain..... what is your time worth hourly, yearly.... what is your quality of life worth???? Place a number on this, then find out what your insurance will cover when submitting a claim then take the cost of the procedure (whatever it may be) and calculate the breakeven based on you activity level and happiness level before PN pain. You might be surprised.
PN started in June 2009, quickly pain level went to 10. PN probably caused from long hours sitting in car, followed by weightlifting/sports daily. My pain level are now daily between 1 and 4. I do not know if I have true entrapment, but definitely know I have neuralgia of the PN.
User avatar
Celeste
Posts: 574
Joined: Sat Sep 18, 2010 2:24 am
Location: central Ohio

Re: Not Taking Insurance......

Post by Celeste »

It's just one of many instances in life in which you will essentially be asked, "how badly do you want it?".
PNE as a result of childbirth, 2002. Treatment by the Houston team, with neurosurgery by Dr. Ansell in 2004. My left side ST and SS ligaments were found to be grown together, encasing the pudendal nerve.

I am cured. I hope you will be, too.

There are no medical answers on the forum. Your only hope is to go to a doctor. I was very happy with the Houston team, which has treated the most PNE patients (well over 400), more than any other US provider.

http://www.tipna.org
Griff522
Posts: 314
Joined: Sun Oct 10, 2010 7:42 pm
Location: Michigan

Re: Not Taking Insurance......

Post by Griff522 »

VT, I just want to say that I totally agree with your post. My husband (and financial coach :D ) has a finance degree and we have lived very frugally during our 18 yrs of marriage. At first, he was very hesitant about me wanting to go to NY for an MRI. His response was, "surely, in this city where there are two medical schools and teaching hospitals, there has to be somebody that can treat this." So I had a MRI done locally and it showed nothing, and the specialists just gave me drugs and no other options. I had to convince him that Dr Potter was the only one that could tell me what was wrong.

And deciding to go to Dellon was a long process for me. Of course, we are concerned about the cost. We are not independently wealthy! But I need to have this surgery done and with the least amount of travel and time away from home, because we have two kids we are responsible for and my husband's job is very demanding.
Burning vulva pain began 10/09
Treated for SIJD 9/10 and burning stopped and pain localized to rt side
Surgery w/ Dr Dellon 5/11 - didn't help my pain
2012 - PT, massage therapy, and ART therapy from chiropractor
MRI showed labral tear and US of groin found hernias
2/13 - surgery for sports hernia
5/13 - still have obturator internus spasms
5/13 - appt with ortho spine dr
8/16/13 - Arthroscopic surgery to rt hip for FAI and torn labrum
Post Reply

Return to “INSURANCE & DISABILITY ISSUES”