No insurance 2/2/10

I spent the night with my leg up on two pillows stacked on top of each other.   My team mate Ortho recommended Tylenol over Advil to keep my blood thin so I took a few but still wasn’t in much pain.  I called my buddy who is fantastic at negotiations and business and asked him to come with me to the appointment on 2/2/10.  I knew I would have a lot on my mind and wouldn’t pick everything up when it came to my billing options.  He (John) had told me that if you pay cash they sometimes give you a large discount.  After ten minutes with the Ortho we spent the next two hours going from one billing specialist to another to assess what would be the best avenue to go down.  As it turns out, if you go through insurance they give a discount for that too.  It was about the same discount, roughly 30% off the up front cost if you pay cash up front or go through the insurance billing route.  I was told by my team mate the whole event excluding PT would run around 10k.  Because I told him I was paying cash he said he could get the MRI waived.  Pow, 2k off the top!  The rest of the costs went like this…   Initial visit to the ortho $120 bucks….   hospital house fee  2k….  15 minute surgery 1.2k…. anesthesiologist $670 bucks…..  percosot $20 bucks…..  borrowed ortho boot and crutches.  Total= $4010.  The surgery fee included three postop visits but did not include casting fees.  All of the amounts show above are after the 30% discount.  If you are paying cash, NEGOTIATE!  Also, become your own advocate in every process of this mess.  Having John come along with me helped out tremendously.  Bring a smart friend to take notes and ask questions if you can.  With strong pushing, I was able to get in for surgery on 2/4 instead of 2/9.  If nothing else, the sooner you get in for surgery the sooner the clock starts on your recovery.  Also, it just makes sense to me that the less time you spend ruptured the better.  My swelling was pretty minimal from the beginning so I was surgery ready pretty much from day one.  Norm of the North (ATR blogger) talks about a recent study that suggests the non surgical route is just as effective for recovery.  It takes a bit longer but doesn’t cost 4k and there is no threat of infection.  Look into it before your decision.  I wish I had.  Also, one of the questions I asked was “if I don’t have insurance are there any low income options?”  In fact, there were but I had already told them that I had insurance so I couldn’t go that route.  I work for myself and have a low stated income that may have enabled me to take advantage of their program if I hadn’t mentioned my catastrophic insurance plan.  Don’t be afraid to ask, it may be worth $100 bucks a word…

One Response to “No insurance 2/2/10”

  1. Thanks for the nice note above:
    “Norm of the North (ATR blogger) talks about a recent study that suggests the non surgical route is just as effective for recovery. It takes a bit longer but doesn’t cost 4k and there is no threat of infection.”

    It actually DOESN’T necessarily take a bit longer! At least the rehab protocol used in that recent study (and 3 others also done in the past 3 years) are quicker than most of the rehab schedules of most of the ATR patients here, surgical or non-surgical.

    You’ve been going pretty fast yourself, but it’s not clear that even that pace (or very close) wouldn’t work without surgery, if somebody worked as hard at it as you did. (I didn’t work very hard, and I skied pretty hard at about 4 months, to your 3.5 months, without surgery. And my AT never held me back, it was just the REST of my body that was whipped!)

    There is a recent report from two Japanese surgeons (linked on my blog about all the studies) who use a new-fangled experimental suture technique and skip the cast AND the boot and go VERY quickly. And their patients seem to be keeping up very well, and getting remarkable results. Mind you, NOBODY on this whole website — and not David Beckham, either! — is getting that treatment, or that schedule.

    So your statement sounds logical, and it may be true when the surgical “cure” gets optimized to maximum speed, but it’s not true of the normal surgery that’s usually done, and it’s certainly not true of the average rehab-protocol speed post-op.

    Congrats on the ski trip, and Keep Healing!

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