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  • Freaking OUT!!!

    Hi everyone! I'm totally freaking out because I was just informed that my insurance coverage for out-of-network doctors is totally changing (for the worse) as of 1/2010. I have surgery scheduled with Dr. Boachie on 1/13 and now I can't do it!!!!!!! Every doctor I have looked up in NYC is out-of-network except for Dr. Errico. Has anyone had their surgery performed by this doctor, or knows anyone who has? I can't believe this is happening! I had everything totally planned for this surgery and now all I can do is cry!! : (

  • #2
    Lisa,

    that really stinks! I am so sorry. Our health coverage keeps getting worse and worse by the year. I'm sorry, I don't know anything about the Dr. you asked about.
    __________________________________________
    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
      Dear Lisa, I'm very sorry for your frustration at this time. However, all may not be lost. A suggestion for you. I had surgery in St. Louis in 6/08. At that time the hospital there was not covered except at a significantly reduced rate by my insurance, and I was going out of state and not to their insurance preferred facility. My local orthopedist wrote to the case manager of my insurance company (which info. I had obtained for him). He explained the highly specialized nature of this surgery, that I had a severe problem, and of the importance of going to a surgeon who was very experienced and did a lot of these surgeries. My insurance accepted these reasons, and my surgery was covered 100%. I could not have asked for more and was very pleasantly surprised. You might try this and may have some luck. I thought the before surgery anxieties were almost more difficult to cope with than the recovery. I wish you the best.

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      • #4
        Hi Lisa...

        Sorry about your insurance issue.

        If you do a search for Errico, you'll see some comments on him by some of his patients.

        --Linda
        Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
        ---------------------------------------------------------------------------------------------------------------------------------------------------
        Surgery 2/10/93 A/P fusion T4-L3
        Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

        Comment


        • #5
          Oh, Lisa. I can't believe it. I just read your post and I am so devastated, as I was really looking forward to going through the surgery with you with Dr. B kind of during the same time frame. That really stinks, I am so sorry. I am so bummed right now, I can't even imagine how you are feeling...

          I just wanted to let you know that there is a girl named "Mixasu" on this forum right now who has a surgery scheduled with Dr. Errico in January. I just read her post and she said she really likes him. Maybe you could send her a message and get some more info on him.

          Talk to you soon. Take care.
          Surgery date: June 8, 2010 with Dr. Boachie
          Thoracic curve: 55 degrees, corrected to 25 degrees
          Lumbar curve: 58 degrees, corrected to 27 degrees
          Posterior-only surgery, Levels T3-L3
          31 year old mother of 2 young kids

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          • #6
            Hi Lisa,

            It's a damn shame that we can't have the Dr. of our choice for such a surgery.

            Do a search on here about insurance issues. If I remember correctly, there is someone here that worked for an insurance agency. Can you ask Dr. Boachie if he would accept your insurance? I don't know what to do, and I feel so bad for you. You have every right to have a Dr. that you are comfortable with, trust and like. That is a huge issue!!!

            Why is Health Care a "right" for some and a "privilege" for others???

            Don't give up, talk to whoever you can, just don't give up!!!

            All my best,
            Shari

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            • #7
              Hi Lisa
              dr errico is an excellent surgeon......he was listed in ny magazine as one of the best orthopedic doctors in the city....his crowded waiting room attests to this...

              i had a consult with dr boachie..but he does not take my insurance...dr lonner & dr neuwirth do...they are wonderful surgeons...i have insurance that pays only for in network doctors...but i have found surgeons of the highest quality within that network!

              i am so sorry that you cannot have the doctor you would prefer & feel comfortable with...i just wanted you to know that there are wonderful scoli surgeons in manhattan that have the best of reputations...for good reason....some of their patients have written of them on this forum...

              best regards
              jess

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              • #8
                Thank you everyone for your replies! This whole situation is so screwed up.
                Wishing, I plan on doing exactly what you suggested. We are in the process of having my primary care physician contact the case coordinator at the insurance company to explain the nature of my surgery and how I need to go to a highly specialized surgeon. I hope this process works! I'm keeping my fingers crossed. Thanks again for all the replies.

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                • #9
                  Everything was approved!!!! We;ll pay as if Dr. Boachie is an In-Network doctor!!! I am sooooooooo happy!!! Hope everyone had a great Thanksgiving! : )

                  Comment


                  • #10
                    That's great news lisa7, now you can move on to the next phase. Good luck with everything.
                    Vali
                    44 years young! now 45
                    Surgery - June 1st, 2009
                    Dr David Hall - Adelaide Spine Clinic
                    St. Andrews Hospital, Adelaide, South Australia
                    Pre-op curve - 58 degree lumbar
                    Post -op - 5 degrees
                    T11 - S1 Posterior
                    L4/5 - L5/S1 Anterior Fusion

                    Comment


                    • #11
                      Originally posted by lisa7 View Post
                      Everything was approved!!!! We;ll pay as if Dr. Boachie is an In-Network doctor!!! I am sooooooooo happy!!! Hope everyone had a great Thanksgiving! : )
                      Lisa,

                      I am so absolutely thrilled for you! You must be breathing a big sigh of relief. As the date approaches, let me know whenever you need to talk, ok? I can't tell you how many pre-surgery pep talks I required.
                      __________________________________________
                      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


                      • #12
                        thank you! I'm totally excited but now the reality is setting in! I started crying at lunch today thinking about everything. Deb, I'm sure you'll be hearing from me. I feel like there is so much to do before the surgery and I can't stop thinking about how things will be after the surgery. I just try to stay positive! : )

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                        • #13
                          Lisa, hang in there! Everything will be fine. I was in your shoes in March of this year and the anticipation part is extremely difficult! However, before you know it, the worse part will be over!

                          This forum is wonderful- it really helped me get through everything!

                          Thinking of you~

                          Rachel~

                          Comment


                          • #14
                            Hi Lisa, great news, now you will have a peace of mind for everything else that has to be taken care of before the surgery!
                            Dolores A
                            June 4, 2009 Anterior L3 - S1
                            June 8, 2009 Posterior T4 - Pelvis
                            Mark Agulnick, MD FAAOS
                            NY Spine & Scoliosis Center

                            Comment


                            • #15
                              Lisa--I'm so happy things worked out for you. I can't imagine thinking you are having surgery, preparing, and then having a major problem like that. You'll do fine and you're lucky you don't have too long of a wait. That was the worst! I had 6.5 months. Follow the exercise advice everyone gives to help get you ready physically and also to help with the stress. I became an exercise fanatic and it helps after with a faster healing I think. Good luck. Janet
                              Janet

                              61 years old--57 for surgery

                              Diagnosed in 1965 at age of 13--no brace
                              Thoracic Curve: 96 degrees to 35 degrees
                              Lumbar Curve: 63 degrees to 5 degrees
                              Surgery with Dr. Lenke in St. Louis--March 30, 2009
                              T-2 to Pelvis, and hopefully all posterior procedure.

                              All was posterior along with 2 cages and 6 osteotomies.

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