For those of you that finally just went to a Chiari Center like Mayfield, did your insurance cover it or was it in-network for you? I live in Indianapolis so the Mayfield Center isn’t far for me at all. However, I have awesome insurance and do not have to pay anything at all for MRI’s, or any tests done through an Ascension Health Hospital (St. Vincent’s) and even for surgery I would only pay $100 total. But Mayfield doesn’t even take my insurance, so my out of pocket to go there would be $12,000 max. Which I would definitely pay it to get someone that has the knowledge and experience with Chiari. My HR department has been wonderful and has called our insurance company and everything looking for a neurosurgeon that even just has the word “chiari” linked to their bio’s and the list is minimal to say the least.
Just curious on your opinions/thoughts about going to a Chiari Center if there was not one neurosurgeon close to you that has had any real experience with it.
I went to Mayfield. My insurance would only agree to pay the out of network costs. My surgery was in October and I still haven't gotten all the bills in yet so I'm not sure what the grand total will be but for me it was worth it. No one I saw in WV seemed to have a clue, I saw a NS at UVA that would have been in network but I didn't feel comfortable with him and while he agreed to do the surgery he really didn't seem to know a lot about chiari. Not to mention the girl who recommended him to me was on a ventilator for 22 days after surgery with him. I went with my instinct and had the surgery done by Dr. Ringer at Mayfield.
I guess I look at it as there should be no amount of money put on my health and with all the possible risks or side effects of any medical procedure I would want some one that knows a lot and knows what they are doing.
I called my primary doctor and asked her to order the full spine mri and cine mri and should know today if she will order it which i am sure she will. Then after those I plan to see one more neurosurgeon here that someone talked to me about and go from there.
I am also in Indianapolis and didn't find any promising ns here. I only actually saw one and decided to just get on with it and go to Mayfield instead of one disappointing ns after another. Mayfield is actually in network for us. If it wasn't I may have tried harder to find someone here, although I did look alot because I wanted to be closer to home. I just don't want to be jacked up because of making a bad decision about my surgeon.
If you don't mind me asking who's the one here that you are going to see?
My husbands mom worked on the neuro unit at Methodist and she suggested Dr.Barbaro who is also with Goodman Campbell Brain and Spine. I had found one publications or study he did on Chiari but can't find it now lol
Our insurance is Blue Cross Blue Shield of Michigan and now I am wondering if they do take that insurance. Mayfield's website does not have it listed but when I log in to my insurance 2 of the surgeons from there are on the list but not all of them and not the actual facility. One of the doctors listed is Phillip Theodosopoulos and on their website he is listed for a Chiari specialist. So I am not sure how that works? Guess I just need to call and find out for sure. Because if they do take my insurance then it would only be $3000 total out of pocket and I would call in a heart beat!
Donna said:
I am also in Indianapolis and didn't find any promising ns here. I only actually saw one and decided to just get on with it and go to Mayfield instead of one disappointing ns after another. Mayfield is actually in network for us. If it wasn't I may have tried harder to find someone here, although I did look alot because I wanted to be closer to home. I just don't want to be jacked up because of making a bad decision about my surgeon.
If you don't mind me asking who's the one here that you are going to see?
Check with either your insurance or the center you want to go to(or both). The listing online(both insurance and provider) is only a guide. They change frequently and there are just too many insurance companies(and probably providers) to have a complete list. There are multiple insurances I see in my office that I am not a provider for, but they make me in network for specific diagnoses or specific patients(it just takes a little more time to get everything together).
another trick is to see an in network MD, mention that you have seen many good comments on whatever center you want, and ask if the provider will write a lteer recommending out of network coverage for that site. In general, no surgeon wants to be the second choice. We would much rather you be comfortable with your decision and can help the insurance company see things your way.
Great, thank you so much for the suggestions! I will definitely call and ask and then go from there.
Dr. Trumble said:
Check with either your insurance or the center you want to go to(or both). The listing online(both insurance and provider) is only a guide. They change frequently and there are just too many insurance companies(and probably providers) to have a complete list. There are multiple insurances I see in my office that I am not a provider for, but they make me in network for specific diagnoses or specific patients(it just takes a little more time to get everything together).
another trick is to see an in network MD, mention that you have seen many good comments on whatever center you want, and ask if the provider will write a lteer recommending out of network coverage for that site. In general, no surgeon wants to be the second choice. We would much rather you be comfortable with your decision and can help the insurance company see things your way.
Yay they actually are in network for me! They took my information and someone from the chiari center should be calling me back.
And my doctor is writing the MRI orders so I can have those done too! I know it will probably take time to get things scheduled and figured out but at least I feel like I am headed in the right direction and not just wingin it lol