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Thread: Decided to visit Dr. Boachie in NY

  1. #1
    Join Date
    Sep 2006
    Posts
    63

    Decided to visit Dr. Boachie in NY

    Hi Carmel and Linda,

    Just wanted to let you know that I have decided to take my daughter to see Dr. Boachie in NY. I had asked Dr. Bradford f(from UCSF) for recommendations for specialists on the East Coast and he recommended Dr. Boachie's name as well. From what I can find on him (on this helpful forum!), he seems to have a solid reputation. I have scheduled an appointment for December and am hoping that my insurance will reimburse me for his fees (apparently, he doesn't accept any insurance).

    Best,

    Sam

  2. #2
    Join Date
    Dec 2005
    Location
    new jersey
    Posts
    850
    sam---I had my surgery with Dr. Boachie & Dr. Kim & only have wonderful things to say! I am 2-1/2 mths post-op and feeling really good these days...
    As with most specialists, he does not take insurance for the initial appmt. It runs about$ 300-400 or so but you can pay & later send it to your ins. co where you should get some back... I think I may have got $150 or so back..
    I have Aetna ins. & as far as the hospital/surgery..it seems to be working out ok on the bills...
    Hospital for special surgery was excellent!! Ly
    http://lynnebackattack.blogspot.com
    fused T-11 to L-5 age 46.......ant/post surgery on Aug 1, 2006..

  3. #3
    Join Date
    Oct 2003
    Location
    Utah
    Posts
    1,010
    Good news Sam. We'll be anxious to hear how the appointment goes in December. Keep us posted.
    Carmell
    mom to Kara, idiopathic scoliosis, Blake 19, GERD and Braydon 14, VACTERL, GERD, DGE, VEPTR #137, thoracic insufficiency, rib anomalies, congenital scoliosis, missing coccyx, fatty filum/TC, anal stenosis, horseshoe kidney, dbl ureter in left kidney, ureterocele, kidney reflux, neurogenic bladder, bilateral hip dysplasia, right leg/foot dyplasia, tibial torsion, clubfoot with 8 toes, pes cavus, single umblilical artery, etc. http://carmellb-ivil.tripod.com/myfamily/

  4. #4
    Join Date
    Jan 2007
    Location
    Pennsylvania
    Posts
    7
    Hello,
    I have posted on a different thread and was hoping someone might repy rather quickly. So I am going to just paste my story here (so I dont have to re-write it. My husband just got off the phone with the office mangager in Dr. Boachies office. She stated that we need to have 80% of the total cost of his charges paid up front in order to keep our surgery appointment. My husband spent all day again on the phone with BCBS and they have authorized our daughter to have her surgery with him, they also stated the dollar amount his office quoted are within their reasonalble charges so they will pay a minumum of 70 % and max of 100% depending on the final bill. At worst it will be 70% of his charges. My husband called his office (DR. Boachies) and spoke with his billing staff, which told my husband that what he was telling her meant nothing...it is not in writing and she has only seen a patient get the amount in writing 2 time in 9 years. So I guess what they are asking us to get is next to impossible. My mother and father were both present at BCBS during this conversation as they were trying to help us obtain this "letter". Also our ins. Broker was given the information directly from BCBS. Unfortunalty since The Dr. is not a particapator of any insurance company the ins. co. will not give them anything in writing. They stated they just dont do that with non participators and that no ins companys will do that. My husband then called Dr. Boachies office again and at the end of the conversation said they would need 50% of his total charges up front as a downpayment. If we can not provide that she will not be having surgery with him, as they will cancel her date. I don't undserstand this at all, we know he does not participate with any ins. but our ins allows us to go with non particapators, its not a ppo or hmo. The percentage they quoted us is in our provider manual. Also since our daughter is disabled, vaccine associalted polio, she has a ssid (medical card) for a secondary coverage. We as a family(and Bethany) have the BCBS, we have had very good exp. with our insurance covering Bethany. My question is, how does anyone secure an appointment with him if insurance companys wont give his office in writing what they need. If anyone here is listening please help. What should I do? Beth is in pro-op traction and to look for another surgeon with his crudentials is not going to happen in the next 2 weeks. We have been in the hospital since january 28. How has anyone here gotten to have surgery with him....did you have to put up 50% down? Did your insurance company give him a letter of what they would pay? If you can give me any advice please do. His office told my husband that he (meaning my husband) is "jerking them around" because he keeps calling them with verbal information $$ from the ins. co and not a written one.....even though they said getting a written commitment from an ins com has only happened 2 times in 9 years? I was taken back at the comments of "jerking around". We are trying so hard to get the letter they need. I guess the odds of getting the letter are so slim, so what do most people do?
    We consulted with Dr.Boachie in January 07 in nyc and loved him, his nurses were also very professional and treated our daughter like the beautiful young lady that she is. Our whole family felt so good after we left there...This was a first after seeing 5 other surgeons, some even turning us down due to the complexity of our daughters case. She is 12 yrs old and 41 lbs, muscle weakness and low pulmonary function around 28%
    Please send your advice..... our email is danpoolscape@aol.com
    Very sincerely,
    The Flanders 570-332-5138
    Last edited by luv4beth; 03-16-2007 at 10:38 PM.

  5. #5
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,802
    Hi...

    Sorry to hear that you're getting such a run around.

    If you remember any of the nurses names, maybe it would be possible to talk to one of them directly. It sounds like the insurance person may be giving you some bad information.

    Regards,
    Linda

  6. #6
    Join Date
    Sep 2006
    Posts
    63
    Dear luv4beth,

    I am so sorry to hear about the difficult time you are having. Like you, I was very concerned about the insurance before I decided on moving forward with the surgery and spent many weeks anguishing over the financial part. Here's what I experienced, and hopefully it will help you.

    When I set up the initial appointment with Dr. Boachie's office they did not provide me with any information on expenditures/insurance. After we met him at the first appointmen (which went great), I said to him directly that I was concerned about the expense of the surgery. He didn't give me any specific reassurances at the time but generally asked me "not to worry" and that "it would work out".

    After a few weeks (it seemed like months to me at that time), I recieved a treatment plan from his office at which point I decided to go for my daughter's surgery (without knowing anything about the costs at that point). For several weeks following my decision, I was terribly nervous because I had mentally committed to the idea that my daughter was going to recieve treatment from Dr. Boachie without having the financial information that I needed.

    Anyhow, I let Dr. Boachie's nurse know that I had made a decision to go for the surgery, and right after that she gave me the finance person's number to work out the financial details. The finance person indicated that she would send a copy of my daughter's treatment plan (and estimated costs) to my insurance company. After my insurance company recieved the treatment plan and estimated costs from Boachie's office, they sent a letter back to them (and me) authorizing the treatment and indicating the amounts they would pay. It sounds like that this is the letter that Dr. Boachie's office wants from your insurance company.

    Has Dr. Boachie's office (or, you) sent the treatment plan + costs to the insurance company? Perhaps then the insurance company can respond with a letter indicating the amount they would be willing to pay for the treatment. I also use BCBS and they were quite happy to send a letter to Boachie's office even though Dr. Boachie's office is a non-network provider. It's odd that BCBS is refusing to give you a letter. I noticed that you mentioned that you talked to your insurance broker about the whole thing? Can you talk to BCBS directly?


    Hang in there,

    Sam

  7. #7
    Join Date
    Oct 2003
    Location
    Utah
    Posts
    1,010
    Beth's condition is almost extreme. I would imagine no one is willing to put numbers in writing, just for the shear fact they honestly don't know what will take place, exactly, during surgery. Like Sam said, sometimes you have to take that very HUGE leap of faith and know it will all work out. Hearing that you are required to pay a huge amount up front doesn't sound good. I hope you can figure out your options. I know you have seen some of the best of the best pediatric orthos in the country. I hope you find the peace of mind you need when you choose where to have her major surgery. It won't be an easy decision, I know. I wish we could be of more help. Email me at boulderfam@hotmail.com if you are interested in having visitors...
    Carmell
    mom to Kara, idiopathic scoliosis, Blake 19, GERD and Braydon 14, VACTERL, GERD, DGE, VEPTR #137, thoracic insufficiency, rib anomalies, congenital scoliosis, missing coccyx, fatty filum/TC, anal stenosis, horseshoe kidney, dbl ureter in left kidney, ureterocele, kidney reflux, neurogenic bladder, bilateral hip dysplasia, right leg/foot dyplasia, tibial torsion, clubfoot with 8 toes, pes cavus, single umblilical artery, etc. http://carmellb-ivil.tripod.com/myfamily/

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