Does anyone know where or how to get the actual statistics of how many Chiari surgeries a doctor performs each year? We are trying to get insurance coverage for an out of state Chiari specialists and want to show the difference in the number of surgeries done by the local ones.
Really want the actual hospital information and not a doctors stated number. I know hospitals track all this, just not sure how to get the info.
I don’t blame you. Go to the www.CSFinfo.org site. I just met the Exec director for the SE and she is amazing, gave me a lot of resources check them out. If you need personalized help Her name is Dorothy Poppe her number is 718-■■■■■■■■. Tell her Jozy in Florida referred you. All the best.
I’m glad you’re disputing this with your insurance. I wanted the best doctor so I ended up paying to use an out of network doctor. I hope you’re able to win this with your insurance.
If you need a good doctor check out Dr Wesley King in Beverly Hills, CA. He’s related with cedars Sinai hospital.
Good Luck!
Than you. We pay so much for this insurance and it makes me crazy.
My insurance just denied my post surgery PT, saying it wasn't medically necessary. They covere
d the surgery but not PT? I don't get it. We fight hard enough just to live... This to gets to be too much some times.
Check with your state insurance board and get the exact laws for your state. In Colorado we have 3 appeals and then we can take it to state insurance board. Appeals have to be done with a set number of days, so read your denial carefully and make sure you file within the time allowed.
I’m determined to be the biggest pain in the but to them!
Have your surgeon write a note about why the PT is a necessity. Research postop outcomes with and without PT. etc.
Hasn’t worked for us yet, but I know for some people just one appeal is all that is needed.
I'm not sure the data you are looking for(Chiari cases) is available to anyone. Hospitals typically track by DRG(Diagnosis related group) so you could see craniotomy, but not specifically Chiari(which is a CPT code 61343).
I've been looking for years and never been able to find it. I really don't think that degree of data is mined/kept anywhere. the data is not in 1 location. Each insurance company has their own set, then the federal government has the Medicare data, each individual state has it's Medicaid data, etc.
Ultimately, you are left needing to trust the MD and hope you find someone willing to be honest. My experience has been, if a patient comes in and advocates for themselves, the MD will usually refer to the MD requested. No neurosurgeon wants to operate on a patient who would rather be operated on by some one else. It does take some forthrightness often. Specifically ask for the referral.
Dr. Trumble,
Thank you for the reply. Unfortunately it is that the local NS isn’t that kind of person. She called the Chiari specialist we saw “aggressive” and arguing that she does not have brainstem compression. Would not say how many decompression surgeries she has done since in her opinion it is not needed.
Sadly the only way to get our insurance to cover the Chiari specialist is to show that he has way more experience.
Dr. Trumble,
Thank you for the reply. Unfortunately it is that the local NS isn’t that kind of person. She called the Chiari specialist we saw “aggressive” and arguing that she does not have brainstem compression. Would not say how many decompression surgeries she has done since in her opinion it is not needed.
Sadly the only way to get our insurance to cover the Chiari specialist is to show that he has way more experience.
I am not sure where you are from but dr dong kim specializes in chiari surgeries he did mine awesome dr he is in housron texas and the hospital is utmb.