In Quest for an Impant... It's happening ... It's on again...

[SeaCapt]

I have Florida BCBS, and Dr. Eid's office handled the paperwork very efficiently. As the ED was organic (caused by cancer), the procedure was covered. There may be some question whether they will cover the actual device- probably a fight you'll have post-surgery, since you don't know for sure what you'll get until you're on the operating table.

[spirit]

Just heard from Dr. Kramer's office today as they have been working on insurance issues etc. They are excellent. The received approval from Obamacare BCBS of Illinois today and it looks like they are covering all but $2,100.00. I was kind of shocked that it all went so easily. Paid the balance and will be flying out on the 24th of September with my Wife. We will be there 3 days after and hope that is long enough for a bit of recovery! I am excited, nervous and in disbelief.

I wonder how long it will take to shake the feeling of being less and of knowing you are impotent. I do actually forget about my condition at times and feel the stirring and then reality bites. If all goes well, it will be incredible to have no fear. I fought "stage fright" for a long time and it will take a while to realize those days are very over... perform at will? Can't imagine.

Flight is booked as well as hotel. Anyone stayed at the Holiday Inn BWI?

[alibaba]

I stayed at the Holiday 2 blocks from UMMC. Dr. Kramer recommended a different hospital but it was pricey. I went for cheap and close. I visited the hotel he recommended while there and have talked to a couple guys that stayed there. I learned he certainly knows which ones are nicest from visiting his patients. Ask the doctor. Hope you have a great time. Baltimore was fantastic. Cheers.

[Bigred]

I stayed at the Holiday Inn. It’s fine. They have a cafeteria that’s pretty good. They also have a free shuttle. Ifyou’re Flying, don’t forget to get wheelchair service on the return flight. You will be glad you did.

[Lost Sheep]

2. I am a what bad can happen guy and used to be paid well for that trait. In this quest, I have read so much about what can go wrong, I need support in what can go right. Please feel free to chime in and share a few post recovery success stories. I am really tired of the depression this permanent state of ED has caused and need something to look forward to.

As a risk management professional, you are paid to focus on what can go wrong. You are also paid to (or work with those who) figure out how to prevent/mitigate the damage and recover from or repair the damage. Certainly, you are aware of the statistics on how often things go right. Focus on that, as well.

In other words, focus on the bright side and keep your eyes on the prize (with a weather eye out for the other side, of course).

[tomas1]

I'm pretty sure his new facility is outside of downtown Baltimore.
If I heard right, it's pretty close to BWI airport.

[David_R]

You are right on both accounts, tomas1. It's in the suburb of Hanover.

[spirit]

Well, it has been a stressful week around here. I received word from Danielle at Dr. Kramer's office that my insurance was denied last Friday. After telling me a couple weeks earlier that all was approved and I was good to book flights and a hotel, the news came that threw everything into a mess. It seems that the info that was requested from my local Dr. was not even looked at before it was sent to BCBS. My Dr. sent medical records but not the addendums regarding ED etc. Of course BCBS denied it as there was no reference to ED. Apparently they just faxed in pages of my medical history without reviewing it.

So, when I was told I was approved, I asked at least 4 times "are you sure", "this is 100% correct", etc.. The answers were yes, book travel it is all approved. I did book travel and we are now trying to get back about $1,200.00. They also had me pay my copayment which was figured out to the last cent... that is being refunded at least so they say.

I am sure Dr. Kramer is work class but the way the insurance was handled and the communication was terrible. They should NEVER have sent in a package of nothing relevant and then ask for me to pay $24k and hope that BCBS would cover it after the fact. Not. They should have given more time without all of the assurances that all was covered. Anyone traveling should insist on approval paperwork before laying out money for travel etc.

Plan B now for me, getting my ducks in a row. I want to be able to fuck, not get bent over trying to do so. Depressed.

[Lost Sheep]

Plan B now for me, getting my ducks in a row. I want to be able to fuck, not get bent over trying to do so. Depressed.

Don't be depressed. The cure for depression is action.

Appeal the denial. Two grounds come to mind right away.

The approval was done. Their mistake. They should own it. Even if their decision was wrong, they gave it to you and should not be able to take it back. Especially since you acted in good faith, made commitments (aside from the fact that they are attempting to make you whole).

The application/approval process is still available. With the paperwork properly done (and complete) approval on the facts (while not assured) through a new application process is possible. Fast-tracking the application should be something they should be willing to do, since you have been inconvenienced by their mistake.

Does your insurance company have any office for grievance resolution? Having one of their own employees to shepherd your appeal/application would be useful, especially if you get that person ON YOUR SIDE. Of course, having someone outside their organization on your side is a very good idea, too. Of course your State (all States have one, but names vary) Insurance Oversight Office should be contacted and presented the facts of your case.

Keep your eyes on the prize. Not on the wake of things past.

[spirit]

After a long time away from this thread my implant is back on and on fast as in tomorrow with a Local Surgeon, Dr. Scott Tiplitsy M.D.. This whole insurance mess caused by Kramer's insurance liaison took a while to sort out.

In the mean time I went locally and had a ultrasound done even though the local implant specialist at UroPartners wanted me to just skip that as it was obvious that nothing was working any longer, no nocturnal erections etc. That test showed very limited blood flow likely due to the penile fracture of 2016 and diabetes. Long story short, they went after Blue Cross and got everything straitened out. I am approved with a small (relatively) copay.

The decision came down to getting this done this year with less than $2k out of pocket or starting from scratch in 2020 with an out of pocket likely 4 times as high. I am nervous about this but feel I have no choice. I am going with the local Doc who seems to do scores of these a year and seems to have passed all of my pointed quiz questions. He will fit me with a Titan tomorrow at 10AM and I will be joining the Bionic Brotherhood.