Spinal surgery Insurance woes
Hello all,
I am new to the Mayo Clinic site, and I am having some difficulty. Well, let's say A LOT of difficulty. I'm not even sure I'm in the correct group to be reaching out but here goes....
I have spinal stenosis. I went to my primary Dr and then started "jumping through the hoops". The typical stuff, injections that last a few days and then surgery. I have actually been needing surgery for some time but now that coughing feels like someone is shooting me in the butt with a taser that shoots down both legs to my feet where it ends in pins and needles, time to act. Long story short, I have been out of work and WAITING for surgery for 8 months now. Original procedure date was March 25th. Pain started December 23rd. My insurance denied my surgery approx. 1 week before my fix date. The then told me that the only way they would pay for procedure was to come here (MC). Everyone here has been wonderful. I gave my nurse, Sue, such a hard time and she's an angel. All be it an angel without answers but certainly an angel. I can guess that if you are reading this you are wondering if my surgery went well. Well, I can't tell ya because it STILL hasn't happened yet! After meeting with Dr Pirris, one fantastic surgeon, he and I agreed that the procedure which my local surgeon recommended was the best way to go. Originally and unbeknownst to me, my insurance "co-partner", CH, wanted MORE. They had taken the liberty in introducing the T.O.P.S. procedure into my "plans". I didn't know that this surgery was on the table, so to speak, until I spoke to Dr Pirris, who was a bit surprised when I said "Uhh...Come again?". Although I was "a Prime Candidate" I really didn't want to go through 6 months of recovery and frankly couldn't afford to. The whole purpose of agreeing to have the procedure done at the MC was because I aint got no mula and I need to get back to work! Especially since my surgery was scheduled March 25th and it was July 1st at the time with surgery scheduled for the 30th, yesterday. How do I feel after surgery? You may be asking.. Wouldn't know because the procedure NEVER HAPPENED. During my chat with Dr Pirris, we talked about how much the 5+ hour travel from Tampa was gonna SUCK. He was so kind as to take the request of moving my surgery back to locally now that the T.O.P.S. party was off the table. With his recommendation as well as the recommendation of the MC's pain management guru, it was, indeed, moved back to Tampa to be executed (probably not the best term) by my original, trusted surgeon. I am here to tell you I was elated. Finally things started to make sense. Apparently, they (CH) were going to attempt some trickery. The idea was to quietly slip in the more invasive T.O.P.S procedure without asking. Guess it took 4 months to get it in. What I thought was a blessing came with a price. Quite literally! Because I wasn't willing to give ANOTHER 7-8 months up and remain out of work, they decided No T.O.P.S. No payments. Now I am out of work, Short Term Disability chucked off on the 28th and 3 days before it stopped, as they say, "exhausted" (Which I see as a perfect term because I am exhausted), my Leaves and Accommodations center for my work (their name starts with an S and sounds like something in a candle or a fantastic movie character with amazing skills) told me "upon further review, you DO NOT HAVE Long Term Disability. OH WOW, I guess the 5-6 calls I had made over the previous 4 months asking that very same question, didn't light up that bulb for them to check that out not just guess and say whatever the brain to mouth filter doesn't catch. So, out without pay, still no pain relief/surgery, and then comes the candle on the cake... Because I opted NOT to do the fancy new procedure and was now having the original slice and dice action on home turf, they're NOT PAYING for it. The whole reason for going to the MC what because I can't afford to have it locally if I had to shell out any cash. That's where I am folks. Waiting for surgery locally and expected to pay out the wazoo. Problem is... my wazoo has been emptied for a LONG TIME. Unbeknownst to them, apparently, it costs money to live day to day. Broke, soon to be homeless, maxed out in debt, family maxed out in debt, and friends already lost over $$, I am lost trying to figure out 1. how I'm gonna pay for the surgery and 2. How am I supposed to live until I can go back to work? There's my story and, trust me, that was the short version. If anyone has any advise, I'm all ears and would be eternally grateful. Big thank you to everyone and to all.... BE WELL.
H
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