neurosurgeon vs orthosurgeon

[Julieanne]

Hi all,

Does anyone have any info that would support an orthosurgeon vs a neurosurgeon? I have found a surgeon at Loyola that I am seeing in June, and my insurance co says that there is a "qualified" neuro guy in my network, so they are fussing about giving me an out of network auth. Even though the neoro guy is not even fellowship trained....I'm not letting someone cut me open that does not have 75% or more of his specialty being adult Scoliosis, just because the insurance quack says so. My PCP is writing a letter of med necessity to the ins, and I'm going to inquire the Physiatrist (phys medicine guy) that I just saw, who told me we DON'T have anyone qualified here, to write a letter of support also.....Wonder how many hoops I'll have to jump through to be fixed??? Ya know, if they said cancer, heart disease or even gastric bypass, the doors of opprtunity seem to fly open!! (no offense to those falling into those catagories) I'm just stating fact, as I myself have fallen into the cancer catagory in 1992-1996. I've pretty much been ignored by the medical community here for over 3 years, I don't hardly think I feel comfortable trusting this kind of surgery to them. So if you have heart disease or breast cancer...Peoria, Illinois is THE place to be, seriously. Anything else major.......I think I'm gonna stick with Loyola.

[green m&m]

Some surgeons are cross-trained in both, but when it comes down to it, you want someone that declared themselves to be a scoliosis specialist. My surgeon did a fellowship at NYU for neurosurgical spine fellowship... he mostly does scoliosis fusions but he does do some neurosurgery (ie tumor resection) when the spine is involved.

[LindaRacine]

Hi Julieanne...

Most neurosurgeons do not go through spine fellowships, but some do. Do you have the name of the neurosurgeon to whom they want to send you?

Regards,
Linda

[katblack]

Hopefully you won't have too many hoops to go through.
I myself jumped through 5 years of insurance BS to finally be able to see the surgeon who did my fusion.

What may have finally forced them to let me be treated by him was a serious letter writing campaign on my part to every state rep and the governor of Florida to intervene in my insurance companies red tape.
They refused to let me see anyone out of network and everyone in network was A) not qualified and B) would not treat me. I was denied by every single surgeon in network and yet they still tried to get one of them to treat me sending me back in some cases, to the same surgeon 3 times or more and each time that surgeon would deny treatment and send them a letter stating he would not treat me and they recommended doctor so and so who is out of network.

It was a lot of BS, a lot of wasted time. Fight for your health care, take it as far as you need to take it to be seen by a doctor who specializes in scoliosis.

[Julieanne]

Thanks for the advice

Hello all...
Thanks for the answers everyone. I had some good news today. The insurance
company is going to get a letter from the Physiatrist that I saw. My PCP said they never got his dictation concerning our visit, so I called his (Phys dr) office, and lo, they did send it to the PCP, but were kind enough to re-fax it to them. I have also requested a copy...I learned that the letter is 4 pages long! The nurse gave me a short overview, and it seems this dr is very concerned that my progression has not been adressed...and instead of getting me surgical intervention, I have been shuffled from specialist to specialist, getting NO help or answers. So, maybe with his letter and my PCP recommendation, this will be easily resolved. Thanks again everyone for your helpful input and kind words!