Announcement

Collapse
No announcement yet.

do you pay cash for dr. boachie?

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • do you pay cash for dr. boachie?

    I have heard that dr. Boachie does not take insurance. does that mean that people on this board who have had surgery with him, have paid cash out of pocket for the surgery? i imagine you would try to recoup from out of network benefits if you have them but please tell me if this is true. cash out of pocket for surgery with him? i know that the first consultation is between 500-650 because they told me that on the phone but if i have to pay cash then i don't need to spend the consultation money. surgery has to be many, many thousands of dollars maybe even 100K.
    thanks to all who will answer me.
    avis
    1987 Lumbar Laminectomy (forget which levels)
    2005 A/P fusion, L2 - L5, 2/2005
    2009 2 Posterior fusions, T6 - Pelvis, 2/10 & 2/18,
    Dr. Frank Rand, NEBH

  • #2
    Hi Avis,

    I decided not to go with him, but I did have a consultation where I paid via credit card. I brought films from another doctor, so my consultation was $450. I sent it into my insurance as out of network, and believe it or not, they paid me back $350. His insurance lady told me that my insurance pays very well, around 70% of his bill. For me it would also depend on if I had a textbook case that goes as planned, or I would haveto stay in the hospital longer. HSS is not in my insurance either. I'm glad I won't have to worry about that as the surgeon I picked is in my network.

    It's hard worrying about these $$ issues as well as the operation itself.

    Good luck,
    __________________________________________
    Debbe - 50 yrs old

    Milwalkee Brace 1976 - 79
    Told by Dr. my curve would never progress

    Surgery 10/15/08 in NYC by Dr. Michael Neuwirth
    Pre-Surgury Thorasic: 66 degrees
    Pre-Surgery Lumbar: 66 degrees

    Post-Surgery Thorasic: 34 degrees
    Post-Surgery Lumbar: 22 degrees

    Comment


    • #3
      Payments to Dr. Boachie

      I have been to see Dr. Boachie 4 times before deciding on having my surgery. For all these visits I paid with a Credit Card (he does not take Discover), and then submitted to my insurance for out-of-network coverage.
      At this time I am trying to find out how much my insurance company will pay for Dr. Boachie's surgery bill. Theresa, the Chief Billing person in the office, has submitted an estimate with the CPT codes. My primary insurance, out of network benefit is only 50% but does have a max. out of pocket. I spoke to my insurance company yesterday and they explained that once I meet the max out of pocket for the year they will pay 100% of the R/C fee. I am lucky as I also have a second insurance under my husbands plan.
      The estimate for Dr. Boachie'e bill is $216,700, this is for A/P revision surgery. I am hoping that with the two insurance's I will not have to pay to much out-of-pocket.

      Arlene

      Comment


      • #4
        Debbei,
        who did you decide to go with if you don't mind me asking?
        avis
        1987 Lumbar Laminectomy (forget which levels)
        2005 A/P fusion, L2 - L5, 2/2005
        2009 2 Posterior fusions, T6 - Pelvis, 2/10 & 2/18,
        Dr. Frank Rand, NEBH

        Comment


        • #5
          Originally posted by theizzard View Post
          Debbei,
          who did you decide to go with if you don't mind me asking?
          avis

          Hi Avis,

          I'm going with Dr. Neuwirth, who is also in NY city. Luckilly for me, he takes Aetna insurance, which we have. For some strange reason, it's the only insurance he takes. His opinion & approach to surgery matched what Dr. Boachie said, and Dr. N could take me months earlier. Those were all factors in the really HARD decision on who to go with. I feel comfortable with my choice, and I'm 2 months and counting till D day.
          __________________________________________
          Debbe - 50 yrs old

          Milwalkee Brace 1976 - 79
          Told by Dr. my curve would never progress

          Surgery 10/15/08 in NYC by Dr. Michael Neuwirth
          Pre-Surgury Thorasic: 66 degrees
          Pre-Surgery Lumbar: 66 degrees

          Post-Surgery Thorasic: 34 degrees
          Post-Surgery Lumbar: 22 degrees

          Comment


          • #6
            Originally posted by 2lucky2 View Post
            I have been to see Dr. Boachie 4 times before deciding on having my surgery. For all these visits I paid with a Credit Card (he does not take Discover), and then submitted to my insurance for out-of-network coverage.
            At this time I am trying to find out how much my insurance company will pay for Dr. Boachie's surgery bill. Theresa, the Chief Billing person in the office, has submitted an estimate with the CPT codes. My primary insurance, out of network benefit is only 50% but does have a max. out of pocket. I spoke to my insurance company yesterday and they explained that once I meet the max out of pocket for the year they will pay 100% of the R/C fee. I am lucky as I also have a second insurance under my husbands plan.
            The estimate for Dr. Boachie'e bill is $216,700, this is for A/P revision surgery. I am hoping that with the two insurance's I will not have to pay to much out-of-pocket.

            Arlene

            You are so lucky to have 2 insurance plans covering you. You really don't see that too much lately. I think fondly of the days my hubby and I had that....now we're paying for family cobra coverage. OUCH...but still, thank goodness for it because that's why I'm able to have Dr. Neuwirth perform my surgery.
            __________________________________________
            Debbe - 50 yrs old

            Milwalkee Brace 1976 - 79
            Told by Dr. my curve would never progress

            Surgery 10/15/08 in NYC by Dr. Michael Neuwirth
            Pre-Surgury Thorasic: 66 degrees
            Pre-Surgery Lumbar: 66 degrees

            Post-Surgery Thorasic: 34 degrees
            Post-Surgery Lumbar: 22 degrees

            Comment


            • #7
              Originally posted by theizzard View Post
              ... has to be many, many thousands of dollars maybe even 100K.
              Avis,

              I just had surgery 6 months ago (an uncomplicated first surgery, fusion and instrumentation from T4-L1), and all the assorted bills (of course my insurance covered most of it) came to roughly $260,000.

              Yowza.

              Pam
              Fusion is NOT the end of the world.
              AIDS Walk Houston 2008 5K @ 33 days post op!


              41, dx'd JIS & Boston braced @ 10
              Pre-op ±53°, Post-op < 20°
              Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


              VIEW MY X-RAYS
              EMAIL ME

              Comment


              • #8
                Doctor Boachie did my surgery in December 2007; I am fused T2 to L2, 11 hours surgery, 15 days at HSS (including an extra 5 days in ICU for pneumonia I got 1 day post-op). For my type of surgery, his fees (and I suppose all other spine surgeons') are based on the number of vertebrae involved: the 1st is one price, the others are all another (slightly lower) price but same amount for each vertebrae. There is a separate procedure code for the "slice & dice" and another code for the instrumention. My bill from Dr. B was $219,500. The other doctors involved (e.g., anesthesiologist) bill seperately, probably $20 - $25,000 total. So far my only payments directly to Dr. B. were for 2 consultations, paid with credit card.

                I had Blue Cross of CA, and all these doctors involved are non-network, so my insurance paid a lower amount (I'm fighting with Blue Cross now because of the pittance they have paid to Dr. B thus far). HSS is in network with Blue Cross of CA, so I paid nothing to HSS - HSS bill was about $200,000 but they were paid about $65,000.

                I consider myself as now having a "million-dollar body" because my subsequent stomach surgery bills were about $230,000 for the hospital (20 days) - BC paid about $75,000 - and about $130,000 - paid about $55,000 - for the surgical team, plus lots of other incidentals such as pre-surgery diagnostics, ambulance, etc, that came close to about $30,000. Thankfully all of these services we in-network, so I had to pay only my annual deductible of $2,400. Also covered fully were the NYC rehab hospital fees (14 days) that were billed at about $200,000 and various doctors and physical therapists at rehab.

                Hope this helps somewhat.
                As of 12/25/07, age 62, 100* thoracic kyphosis, 73* L1-S1 lordosis, 37*/25* compensatory S-curve scoliosis. On 12/26/07, Dr. Boachie @ HSS NYC did 11 hours ant. & post. procedures, fused T2-L2, kyphosis now 57*, scoli 10*. Regained 2 1/4 inches in height!! Improving every day.

                Comment


                • #9
                  Paying cash out of pocket?!? Good Lord, no. My insurance plan (NY-based Blue Cross, since my husband's employer is headquartered in NY) paid for almost 80 percent of Boachie's total bill, and he wrote off the difference after I called Theresa and basically asked her if I HAD to pay it. My hospital stay was totally covered. We did end up paying a few thousand in out-of-pocket fees, but in the grand scheme of things it was well worth the expense.
                  Chris
                  A/P fusion on June 19, 2007 at age 52; T10-L5
                  Pre-op thoracolumbar curve: 70 degrees
                  Post-op curve: 12 degrees
                  Dr. Boachie-adjei, HSS, New York

                  Comment


                  • #10
                    I had surgery at the end of May this year and my bill for the hospital and surgery was $280,000. Adding all the other stuff in, it was well over $300,000. This was done in the Philadelphia area.
                    Chemist, 30

                    1998- 18 degrees
                    2003- 33 degrees
                    2005- 37 degrees
                    2006- 44 degrees
                    May 2007- 47 degrees
                    December 2007 - 50 degrees X-ray

                    Surgery May 27, 2008
                    Fused T1 to L2
                    Curve corrected to 15 degrees X-ray

                    Comment


                    • #11
                      well it sounds better than i had thought. i really was beginning to think that i needed a couple hundred thousand laying around with nothing to do. i am reassured. i have personal choice with out of network benefits so they do pay something, thanks everyone/
                      avis
                      1987 Lumbar Laminectomy (forget which levels)
                      2005 A/P fusion, L2 - L5, 2/2005
                      2009 2 Posterior fusions, T6 - Pelvis, 2/10 & 2/18,
                      Dr. Frank Rand, NEBH

                      Comment


                      • #12
                        This is kind of unrelated...but I'm just wondering because I live in Canada....do Americans have to pay for surgery for Scoliosis?
                        If so, approximately how much?
                        17 years old - Female - Canada
                        Had fusion surgery June 26th, 2008
                        Feel free to ask me ANY questions about my experience!

                        Comment


                        • #13
                          Originally posted by tillgurl View Post
                          This is kind of unrelated...but I'm just wondering because I live in Canada....do Americans have to pay for surgery for Scoliosis?
                          If so, approximately how much?
                          Tillgirl, I had to stop laughing before I could answer .

                          Yes, hon ... in America, pretty much if you don't have insurance (or aren't under 18 - Shriner's Hospitals will operate for free on anyone from birth to 18 - and in special cases, I believe even on over 18's who were treated prior to their 19th birthday), you don't have this surgery. Few people have the monetary resources to self-pay.

                          America in no way operates under a socialized medicine system. We pay monthly premiums for insurance coverage, and there are different types of plans:

                          An HMO (Health Maintenance Organization) plan requires the insured to see their PCP (Primary Care Physican ... just their general practioner) for a referral to any specialist. The downside to this is a LOT of GP's don't know sh** about special conditions, and the HMO itself does all it can to save the money a specialist demands.

                          A PPO (Preferred Provider Organization) has a list of GP's and specialists they consider "in-network" (the term you see so much). They have contracted prices for services with these doctors, and the doctors are not allowed to charge over that price. Out-of-network benefits (to doctors who aren't contracted in the plan) are usually much less, and have a completely separate deductible (the amount the patient has to pay before ANY insurance benefits are paid).

                          Recently, a new type of insurance has surfaced ... the HDMP (High Deductible Medical Plan). This is what I have. My out of pocket expenses before insurance pays is $2500 - and then everything is paid the rest of the year at 100%. I scheduled this surgery in late 2007 for early 2008 - and enrolled in this plan knowing I'd have excessive medical expenses in 2008. I met everything (deductible, out of pocket, etc.) in February 2008 - and all my expenses are covered completely for the rest of the year.

                          You can also set aside tax-free monies (in either flex spending accounts or health savings accounts) to help you pay out of pocket costs.

                          There are obvious downsides to a non-socialized system (for instance, not having insurance and needing scoliosis surgery ... which to answer your question averages $250,000 - $300,000 ... and easily more for complex revision surgeries).

                          There are also upsides: We don't have to wait months (usually) for appointments and medically necessary surgeries, and we can schedule even elective surgeries without delay. That convenience comes with a hefty pricetag.

                          Feel free to ask away if you have other questions! I'm sure I've made it clear as mud ;-).

                          Regards,
                          Pam
                          Fusion is NOT the end of the world.
                          AIDS Walk Houston 2008 5K @ 33 days post op!


                          41, dx'd JIS & Boston braced @ 10
                          Pre-op ±53°, Post-op < 20°
                          Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


                          VIEW MY X-RAYS
                          EMAIL ME

                          Comment


                          • #14
                            so, in other words, dr. boachie takes what he gets from our insurance even if he is not a participating member and we don't have to pay the difference?
                            avis
                            1987 Lumbar Laminectomy (forget which levels)
                            2005 A/P fusion, L2 - L5, 2/2005
                            2009 2 Posterior fusions, T6 - Pelvis, 2/10 & 2/18,
                            Dr. Frank Rand, NEBH

                            Comment


                            • #15
                              Originally posted by theizzard View Post
                              so, in other words, dr. boachie takes what he gets from our insurance even if he is not a participating member and we don't have to pay the difference?
                              avis
                              I think it depends what % your insurance pays. I've heard that some insurance plans only pay 10-20% of his bill; in that case he would need to collect more.
                              __________________________________________
                              Debbe - 50 yrs old

                              Milwalkee Brace 1976 - 79
                              Told by Dr. my curve would never progress

                              Surgery 10/15/08 in NYC by Dr. Michael Neuwirth
                              Pre-Surgury Thorasic: 66 degrees
                              Pre-Surgery Lumbar: 66 degrees

                              Post-Surgery Thorasic: 34 degrees
                              Post-Surgery Lumbar: 22 degrees

                              Comment

                              Working...
                              X