Insurance vs Self Pay

[Floridaspeedo]

I almost went self-pay. My surgery was postponed twice as the approval had not come through. I looked at paying upfront then getting reimbursed but even the hospital did not recommend that approach.

If you are going to self pay, be sure you reach an agreement to only have to pay what an insurance company normally would have paid.

I see the bills coming in for the implant and was like wow. This wasn't brain surgery.

What the hospital and doctor received were substantially and I mean substantially less than the amount theyy billed the ins company.

[DougAnd]

WOW. Proximal perforation is almost the same as distal crossover but in the opposite direction. How did that happen? Did you have peyronies or something?

That is a long story and I do not wish to start the mess that seems to occur with this or any other man that had problems with this doctor. It would highjack this thread to something not intended. If you would like to talk about this I would be willing to do so just send me a PM.

I can already see what I needed to know. You are not the first to have problems with him but not this kind. It just goes to show that there is no 100 percent assurance, every surgery is taking a chance. I had thin tissue because of VED usage. It is possible that even the best of the best would have screwed it up. We all need to realize that if you need an IPP then you have a diseased penis. And if you have a diseased penis it's kind of like a box of cracker jacks, there's a surprise inside every time.

[MK1965]

You are not alone. I had lots of problems with my first implant which was not installed correctly. For 2 years, I was telling my doc about pain with inflation and pain during and after intercurse. He would just nod his head and said: Everything is okay to him and he doesn’t see anything wrong. After 2 years of complaining, he ordered MRI of penis in deflated and inflated state with gadolinium. And BUM. It came back with proximal cross over where my right RTE ended up in left crus together with left RTE.
After I found doc for revision, I fought battle with my insurance to get approved despite same insurance paying first time with no problems. Finally, after second level of appeals, it was approved.
My second implant was done by right guy with lots of experience with excellent satisfaction and function. No more pain during and after intercurse, while inflation for length maintenance or for flying solo.
MK

[newbie443]

I can already see what I needed to know. You are not the first to have problems with him but not this kind. It just goes to show that there is no 100 percent assurance, every surgery is taking a chance. I had thin tissue because of VED usage. It is possible that even the best of the best would have screwed it up. We all need to realize that if you need an IPP then you have a diseased penis. And if you have a diseased penis it's kind of like a box of cracker jacks, there's a surprise inside every time.

Most all his vids are down now. And in the past he added new ones dropping off old ones. I saw another vid of a man who was back with him after having the first with him. The man had an infection and a proximal perforation. So there have been others. And no I did not have Peyronie's or something. I went into surgery pointing straight froward with the partial erections meds would give me and came out pointing hard left. I am still straight from my base to the tips of my glans but pointing left and have pain when I try to push it pointing straight ahead. Again there is a lot more to this than you understand and I would be willing to talk with you or anyone else about but this thread is is not the place.

[nuance]

Do you guys know if a US employer can find out that we had this expensive surgery and used insurance for it? I'm assuming the insurance company might share this information with them as in most cases it's the employer that's managing the fund and paying for it.

[nuance]

I almost went self-pay. My surgery was postponed twice as the approval had not come through. I looked at paying upfront then getting reimbursed but even the hospital did not recommend that approach.

If you are going to self pay, be sure you reach an agreement to only have to pay what an insurance company normally would have paid.

I see the bills coming in for the implant and was like wow. This wasn't brain surgery.

What the hospital and doctor received were substantially and I mean substantially less than the amount theyy billed the ins company.

Are you saying the doctor/hospital usually bill them high but end up taking whatever the insurance ends up paying (I'm sure there's some back and forth)? If we went out of pocket, we'd have no idea what the total cost would be?

[Gt1956]

Nuance: Don't even bother looking. The discounts applied & payments made are considered business secrets. It would take an army of lawyers & lots of luck to find out. Don't try to make sense of it. Usually, the best guess is the cash pay price is pretty close to the insurance rate.

[Floridaspeedo]

Ask what the cash price would be.