1. < Prostate Cancer

Silly accounting tricks

Posted by garylr @garylr, 2 days ago

So, I'm nearing the end of my treatment - 6 months of ADT with 28 sessions of photon EBRT in the middle.

I'm looking at the Statement of Benefits from my insurer (Humana Medicare Advantage), and this is what my treatment cost came to:

Fiducial markers and SpaceOAR procedure:
Billed: $27,589.56 Humana paid: $5,103.53 I paid: nothing

Simulation, post-sim MRI and planning:
Billed: $12,961.30 Humana paid: $2,184.44 I paid: nothing

28 EBRT treatment sessions:
Billed: $82,297.60 Humana paid: $14,957.04 I paid: nothing

6 "Doctor Day" consultations during radiation:
Billed: $4,086.00 Humana paid: $1,171.93 I paid: nothing

6 months of Orgovyx:
Billed: $15,879.72 Humana paid: $15,579.72 I paid: $300.00

So, if my math is correct, the providers billed my insurance $142,815.98 and Humana paid $38,996.65. I'm out of pocket $300,00.

What a system!

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heavyphil | @heavyphil | 21 hours ago
In reply to @survivor5280 "I don't have all the bills in yet for my prostatectomy but I'm sure it'll end..." + (show)
@survivor5280

I don't have all the bills in yet for my prostatectomy but I'm sure it'll end up being around that amount by the time everything is accounted for - that $10K was only the fee my actual surgeon charged for the procedure.

There was another urologist that I consulted with who was just like yours - he was such a pompous dill weed, so full of himself and had the Ferrari outside, upon further investigation he not only had 1/5th of the prostate surgeries under his belt but was rated as below average on outcome and way below national average on patient satisfaction. He was a hard no.

So, like you, I'll take my humble train collecting, figuring hoarding, VW driving surgeon every day of the week! He's kind of a weird dude but he's a good man and an excellent surgeon. But then again, who is to say that your surgeon isn't top notch and couldn't do more than what was done? You never know, I got dealt a good hand but so many others did not.

Jump to this post

Oh absolutely, he is an excellent surgeon- helped pioneer the daVinci robot and teaches it overseas in fact.
I did not go to him because of his celebrity; I was totally unaware of his position in the surgical community. In fact, he was under fire in the press because he was the highest paid surgeon in NYS and was being sued for being out of the room or some such during surgeries….not true. He was a word of mouth referral from two of his patients. He took no insurance and participated in none….nice work if you can get it, right?
But I do give him a lot of credit for my continence; unlike you I did ZERO pelvic floor exercises except for some Kegels (done incorrectly) a few days before surgery.
I had a couple mishaps early on but nothing for years, so I’ll take the ED if that’s the price I have to pay for having 90% cores of Gleason 4+3 unfavorable in three quarters of the gland. I’d say his gold cufflinks were worth it😂

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