Where to go? How to pay?

[Mentu]

I've found many of your dicussions helpful but there are still unanswered questions as I wait for my next appointment with my cardiologist. The heart cath went well and I don't have other heart disease. So at our next meeting, we will talk about where, who, and when. Choosing a place doesn't seem all that hard if cost is of no concern. Everyone wants to go to the best place but how do you pay for it? Out of state, my insurance company could leave me expossed to financial ruin. From here, the choices seem limited. Obviously, one makes the best compromise but I see no way to even consider the "best" place. Am I missing something?

Mentu - Waiting in Tulsa.

 

[Marguerite53]

I'm sure they know how to perform heart surgery in Oklahoma!! Many of us do not travel outside our area. I was perfectly satisfied to stay in the Portland, Oregon metro area for mine. I had no complicating factors going in or coming out!

There is no need to bankrupt yourself!! This talk with the cardio will be good. I'm sure he has a surgeon and a hospital in state that he and you will trust.

I did a brief search here on VR.com for Oklahoma hospital and came up with some threads. Perhaps a deeper search here, for info on your home state would be helpful. Or you could start a new thread asking about OK hospitals in the thread title.

Breathe. It's gonna be fine!

Best wishes.

Marguerite

 

[MaryC]

The best place might be in your own state. When I started doing my research after I finally accepted I was going to have to have surgery, when I started doing my research, my surgeon was right here in Dallas, TX. My brother and sister-in-law both had valve replacement surgery at the Heart Hospital in Oklahoma City. I did my research via the internet but some people do so by asking other people in their area where they had surgery. Like Marguerite, I used VR. COM as a resource. You may be surprised.

Chris

 

[JimL]

Your family is a very important part of recovery from the surgery; it is good for them to be there for you, it is good for them to be able to visit in the hospital easily, it is good for you not to worry about them. All of that can indicate that close to home is the best place for surgery. I chose a hospital 45 minutes away over a better one 75 minutes away from home for just that reason.

 

[ALCapshaw2]

Hospital and Surgeon Choice depend a great deal on what you need done.

Local Hospitals can be Very Good for normal Bypass Surgery and maybe even simple first-time single Valve Replacement.

State / University / Heart Center types of Hospitals probably have more experience doing Valve Replacements.

Specialists are desirable for more complex surgeries such as the Ross Procedure, multiple Valve Replacements, Re-Do's, and Surgery of the Aorta (to repair aneurisms). This is where traveling out-of-state becomes more of a concern.

Ask your Cardiologist who he recommends for what you need done and start from there.

 

[Lionheart]

Mentu,

I checked my insurance company's website for information and a list of Providers that were part of their network. When I was looking at out-of-state hospitals I also checked on the hospital's website to see if they were a participating provider.

My opinion is that the surgeon and hospital support staff have a greater influence on a positive outcome then how convenient it is for family or friends to visit. Although I also think it is important to have at least one family or friend as an on-site caregiver during your hospital stay.

Good luck,
John

 

[kfay]

I also checked my insurance companies' web site and found that I could go the Mayo clinic in-network. If I didn't have a condition that very few surgeon's have alot of experience with, I probably would have preferred to stay closer to home. I'm sure you can find a very good, competent surgeon somewhere in the state of OK. It is not worth financial ruin if you can help it.

Kim

 

[sknydave]

First find out what hospitals your insurance works with, then find the best surgeon you can working out of one of those hospitals. Are you just having a bread and butter valve replacement? It's fairly commonplace these days, so I wouldn't worry about having to be at the best rated hospital in the country.

 

[Ross]

Many insurance companies will allow out of network coverage at in network pay outs provided you are referred to such a place by your physician. You might want to call your insurance co and see what they have to say. Don't rely on their simplistic benefits manual to tell you all the ins and outs.

 

[goffrey]

You can ask for what is called an "exception to policy to go out of network"...give reasons as to why you need to use that specific doctor and facility...if they are a higher volume hospital for your procedure show studies that link high volume to better surgical outcome...they can be found by googling them in....If you are denied then appeal and get letters from your cardiologist and surgeon and the studies... We were denied going out of area by our HMO years ago and I appealed and won on appeal....Most insurance companies will expedite an appeal if your condition is life threatening to less than 30 days.....