Medical Costs - Dr. Boachie

[susannajon]

Hi Everyone,

I know many of us who are going somewhere other than Shriners for surgery worry a great deal about money, and there are some who might stay away from a particular doctor or hospital because they are scared of the out-of-pocket expense.

I just wanted to share a piece of good news. My daughter went to doctor Boachie-Adjei at the Hospital for Special Surgery. We have CIGNA PPO. The doctor is out of network, and our coverage is 60/40 with a $3,000 out of pocket limit (NOT including co-pays for office visits, etc.).

All the pre-op testing, the MRI's, the second opinions, the x-rays, and the hospital bills totalled about $125K. We paid about $5,000 out of pocket. Dr. Boachie's bill was $37,700. The insurance company paid about $27,200, and Dr. Boachie WROTE OFF THE REST! He is an angel disguised as a man, I swear! It's a lot of money, but we won't have to mortgage the house to pay the bills, yeah!!!

Anyhow, just wanted to give folks a realistic idea of what those bills will look like. It should be noted that the hospital will also work with you to set up a payment plan for the balance owed to them, and they offer financial aid to those in need.

P.S. My daughter is doing extremely well, back to school, straight back, and virtually no pain.

[nicoles mom]

WOW
HOPE THE SAME IN IN MY CASE. MY HUSBAND HAD BEEN OF WORK FOR THREE MONTHS AND I WILL SAY THE HOSPITAL IS GREAT BECAUSE WE WERE ABLE TO SHOW THIS AND GOT A DISCOUNT WE DIDN'T GET DR BOACHIE BILL YET.
THERESA

[nikyergen]

I am so glad to hear that you had such wonderful consideration by your doctor. We used Shriners because they have some of the best doctors in the nation at them.

[susannajon]

Yes, Shriners is wonderful from what I've heard, plus the free care, including PT and such is a godsend for thousands of children and families every year. For our particular situation, we felt Boachie was the best choice. I just want those who have shied away from him for fear of ending up in the poor house to know that the out-of-pocket cost for such a major surgery isn't nearly as bad as we had anticipated.

Susanna

[nicoles mom]

Susnanne

Well I Had To Tell You I Too Agree With You He Is An Angel.

I Was Very Worried From The Begining That We Were Over Are Heads. With My Husband Out Of Work And The Costs Of The Surgery We Faced. There Were Other Doctors And Hospitals That We Could Of Gone To That Took Our Insurance With No Out Of Pocket Expenses. But Dr Boachie Was The One We Wanted For Our Baby So We Went For It. I Would Of Sold Everthing I Owned If I Had To Anyway (glad I Didn't Have Too). We Have Ghi Ppo And They Paid 90% Of Are Bill And He Wrote The Rest Off. Her Brace Costed Us The Most Money $2800.00 Which Was Another Out Of Network. But Dr. Boachie Wanted Us To Use Him My Insurance Company Paid Us Back 462.00 So Sad.

Thank God My Husband Is Back To Work Now And My Nicole Is Doing Great.
Theresa

[carolnj]

I'm so glad to hear that everyone is doing well and that the costs for surgery have been manageable and some balances even forgiven by the medical specialist! That is impressive!

We have Oxford and according to my paperwork, the hospitalization will be covered 100%; surgery is covered 100%. I am not sure of the rest. Our surgeon's office handled all the pre-certifications and listed all the big experts who worked on our son; the spinal surgeon and his assistant, the thorasic surgeon, the anestesiologist; the spinal cord monitoring person - we don't know if other people who may have had some hand in his care that we were not aware beforehand will be covered or not. We haven't received any bills yet. But, I have to say with all honesty that after seeing what my son went through with his surgery and how well he was cared for, whatever the bills are, we will deal with them, even if I have to pay on them for the rest of my life. I have never seen anything so amazing and just seeing how straight he stands now is worth everything we may have to give up to pay any outstanding bills.

[susannajon]

Carol, AGREED! It's not the cost that matters, but the skill of the surgeon. I would have mortgaged the house and liquidated the 401K if I had to, but fortunately, we didn't. Boachie's office was wonderful. They helped us estimate our out of pocket expense in advance, and they were right on target, and God bless him for writing off the difference.

Theresa, I am so glad Nicole is doing well and your husband is back to work. Boy, when it rains it pours, doesn't it? How long will Nicole need the brace?

Susanna

[nicoles mom]

Susanne
Nicole Has To Wear Her Brace Until Her Body Stops Growing Plus We Are Hoping For A Correction In Her Lumbar. The Brace Has Been A Nightmare Dealing With During Recovery. She Is Sleeping In It Now And Is In It About 21 Hrs A Day. We Go Back Aug 8 Hopefully The Xray Will Show The Brace Is Working. If Not We Are Looking At A Second Surgery Down The Road I Pray This Won't Happen.
Theresa

[Lori]

Thanks for info on Dr. Boachie

Hi,
I'm new to this forum. My 15 y.o. daughter is scheduled to have surgery with Dr. Boachie on 7/20 and I'm really frightened about the whole thing...including the finances. Your comments were very reassuring. But my biggist issue of concern is that my daughter's spine is considered a borderline surgery case but she wants the surgery. She has two curves and a rotation but because of the position, it is quite noticeable and she does have back pain. I'm not even sure exactly where the fusion will be but it is low, in the lumbar area. I'm going to see if I can find some other parent's of teens who had the fusion in that area...I fear that the lower lumbar region may come with special problems.
Anyway, I'm glad to hear your experience at the hospital was positive. I have found Dr. Boachie's office staff to be very helpful and well organized...it really does make a big difference. One last question: Did you sleep at the hospital after the surgery? Good luck to you. I'm so glad to hear your daughter is doing well. Lori

[nicoles mom]

Lori
Welcome To The Forums
Your In Good Hands He Is A Wonderful Surgeon. I Did Stay At The Hospital By My Daughters Side The Whole Time They Have A Chair That Turns Into A Bed Bring Yourself A Blanket And Some Comfortable Cloths. My Husband Stayed At A Hotel Nearby We Didn't Take Turns Staying With Nicole At Night She Only Wanted Me Which Was Very Exhausting. During The Day I Would Go Back To The Hotel For A Quick Shower And A Change Of Cloths. We Were In The Hospital For Seven Nights. If You Have Any Questions About Anything I'm Here.
Theresa

[Lori]

Theresa,
Thanks for the welcome and for the information. My daughter also requests that I stay with her while she's in the hospital.
Was your daughter alert during the hospital stay or did the pain meds keep her in a semi-conscious state?
I'm sorry to hear your daughter is still wearing a brace but if it can prevent another surgery it will be worth it. Good luck.
Lori

[nicoles mom]

Lori
Her Surgery Was Over At About 7:30 Pm So She Stayed The Night In Pacu unit This Is Where They Go After Surgery Its On The 4th Floor. I Spend My First Night There At About 2:00 O'clock In The Morning They Gave Me A Chair That Reclined Which I Was Able To Dose Off In. If I Sleep An Hour It Was Alot. They Kept A Close Eye On Her She Was In And Out And In Alot Of Pain But She Had A Pump To Give Herself Pain Meds I Was Pushing It For Her Because She Wasn't Able To Do It Herself.
She Doesn't Remember Being In This Room So She Was Very Much Out Of It. She Did Know I Was There And Was Talking To Me And Holding My Hand. Then She Needed A Blood Transfusion At About 3:30 In The Morning. These Happens With Lost Of Blood During Surgery And They Will Tell You To Donate Blood Just Incase You Need It. My Husband Came Back To The Hospital At 4:00 Am And They Let Us Both Stay With Her.
She Was Then Taken To Her Room On The 5th Floor. I Don't Mean To Scare You But She Will Be In A Lot Of Pain And Each Day Gets Better. The Morphine Pump Gives Them Meds Every 10 Minutes 4x An Hour And If They Still Have A Lot Of Pain They Call Pain Manager They Will Give Them A Shot My Nicole Had Them Come Maybe About 7 Times She Didn't Do Well With The Pain. She Is Only 12 And Was Having Panic Attacks And The Morphine Was Making Her A Little Crazy.
There Started Giving Her Oral Meds On Day 4 Every 4 Hrs. Make Sure You Watch The Clock And Called The Nurse So She Gets Her Meds On Time They Won't Gave Them To Her You Have To Ask Some Of The Nurses Will Bring Them Others Don't. I Learned That The Hard Way. Everybody Told Me This On The Forum To Watch The Pain Meds . But We Had This Nurse Who Gave Them To Her Every 4 Hrs For Two Days I Never Asked So I Assume At This Hospital They Took Good Care When Giving The Meds On Time I Was Wrong So Just Keep Track For Your Daughters Sake.
Theresa

[Lori]

Theresa,
Thanks so much for the heads up on the pain medication..and for all the other information as well. I had some surgery myself several years ago and I was on a morphine pump and I remember feeling really nauseated from it in the middle of the night. Of course, feeling sick from the pain meds when you've just had surgery is the worst. I pray my daughter won't have that reaction.
My daughter donated some of her own blood last week and now that we know her type, I will give another pint this week. I just assumed the transfusion would be during the surgery, if at all. Now I'll be prepared just in case she needs it post-op. My daughter doesn't cope too well with any kind of physical discomfort so I know this is going to be difficult.
How did you manage getting home from the hospital? I've read that having lots of pillows available in the car is helpful. I rented a hospital bed for when she gets home and purchased a lift, with arms, for the toilet seat. Anything else you recommend? Thanks again, Lori

[nicoles mom]

Lori
I Live In Suffolk County We Left The Hospital At 7:30 At Night So Traffic Wasn't So Bad My Sister Drove Us Home She Has An Suv. Nicole Sat Up Front With Lots Of Pillows. It Took Us 1 Hr To Get Home We Stopped Twice To Ajust Her Pillows. My Sister Also Brought A Step Stool So It Was Easy To Get Into The Car. She May Not Even Need The Blood She Donates Their Was A Girl Who Also Have Surgery The Same Day And She Didn't Need A Transfusion. I Would Get A Shower Seat. I Also Got Nicole A Longer Shower Hose For The Hand Held Shower Head In The Tub. At First I Had To Help Her In The Shower So The Longer Hose Was A Blessing.
What Type Of Fusion Is Your Daughter Having? Nicole Had A Posterior Fusion T-4 To L-1 Her Curve Was 58 On Top 55 On The Bottom Now Shes 19 On Top 40 On The Bottom And Wear A Brace 23 Hrs To Hopefully Corret The Lumbar Or Stop It From Getting Worse.
Theresa

[Lori]

Theresa,
My daughter is having anterior thoracolumbar spinal fusion where the Dr. enters through the side and takes bone from a rib. I'm not sure exactly what segments are being fused . When we last met with the surgeon I was so anxious that I didn't write down the specifics. He showed us the post-op x-rays of a child with a very similar curve and the fusion involved about five inches of the lower spine. My daughter's curves are not as bad as many I've read about (lumbar is 45) and upper is about 38 but because her curve is so low it was recommended we do it before it gets worse. She also has a slight hump from the upper rotation, her trunk shifts to one side, and her pelvis is uneven. She complains of back pain and she wants to have the surgery. It was a difficult decision for me. I hope we are doing the right thing.
Thanks for the suggestions for the shower. We live in Brooklyn so thankfully our ride home will be relatively short.
Did your daughter go for physical therapy after the surgery? Lori