dr dake and health insurance

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

dr dake and health insurance

Postby zap » Wed Jun 24, 2009 9:59 pm

Can anyone tell me about how this works out? I have health insurance through my job, it's not great but it's OK ... ar there problems to anticipate? Have others submitted claims, and how large was the expense, etc?

:?:

I love Northern CA and have some vacation time to use up this summer ....
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Postby Loobie » Thu Jun 25, 2009 4:49 am

Call Angela, Dr. Dake's assistant. She gave me the CPT codes so you can get your dr. to refer you. It ain't cheap, but most standard plans will look at it as major medical out of network and most of them will pay anywhere from 60% to 80%. The only way to get a good number is to actually vet the process and have them run it through your insurance.
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Postby Sharon » Thu Jun 25, 2009 5:52 am

I am on Medicare and also a Supplement plan. Everything was paid for.

As Loobie said, call Dake's assistant - I did not need to do anything, she did it all. BTW - Angela has an assistant now who is taking care of scheduling and insurance.
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Postby javaneen » Thu Jun 25, 2009 6:55 am

Wow! An assistant to an assistant. They must be busy there at Stamford![/quote]
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Postby cheerleader » Thu Jun 25, 2009 7:01 am

Dear Angela was too busy to take on all the MS patients- plus her regular work load, so Dr. Dake brought on Alexandra to help with insurance and scheduling issues.

Alexandra Duran Washburne
Dr Michael Dake/ Scheduler
o: (650) 725-3806
Stanford Hospital/ Cath Angio Lab
o: (650) 723-7676
f: (650) 723-7446
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Postby zap » Thu Jun 25, 2009 8:23 am

I am in an odd position - I don't actualyl HAVE a GP doc - I have not had a doctor since my pediatrician - until I was dx with MS after a visit to an eye doc who sent me for MRI, and I got myself a neurologist.

But of course my neurologist doesn't approve of CCSVI model (see Skeptics thread), so I have no one to refer me ...

I wonder if Dake knows any docs in the Minneapolis area I could go to who would be supportive?

Selecting a GP from scratch was daunting enough before - trying to find someone who is good AND will be willing to refer a new patient for this seems unlikely? And such a short window of opportunity (this summer) ...
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Postby peekaboo » Thu Jun 25, 2009 9:10 am

zap - here's a lead or two

Minnesota

Mayo Medical School
Mayo Clinic College of Medicine
200 First Street, S.W.
Rochester, MN, 55905

University of Minnesota Medical School
420 Delaware Street S.E.
Mayo Mail Code 293
Minneapolis, MN, 55455
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Postby whyRwehere » Thu Jun 25, 2009 10:25 am

In my experience, GPs are much more open to meeting the requests of their patients. They know there is not much else out there for us, so why not try something that won't hurt....
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Postby coach » Thu Jun 25, 2009 10:53 am

I went to a new GP last week for elevated blood pressure. I liked him very much. We discussed CCSVI and he was supportive. He mentioned that he had a good friend with MS. I told him I could drop him a copy of some of the research by his office which I did. I think if I need a referral for insurance purposes he would give me one. Also my husband is friends with a cardiovascular doc and I think I could get one from him if needed. Has anyone had a neuro that has been receptive to the idea? General consensus seems to be that they are not.

I called Dr. Dake this moorning and spoke to him briefly. Very nice. He took a little info and said he would have an assistant call me later. I get the feeling they are very busy with requests. And I agree there is not much out there that is beneficial to those with this disease. I have insurance too, but it is going to be interesting how this plays out insurance-wise. I told Cheer in a PM that maybe we can get Michelle Obama involved since her dad died from MS related complications, at least I think that's correct.
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Postby Sharon » Thu Jun 25, 2009 11:50 am

Zap -

Are you sure you need a referral with your insurance? HMO plans would require referral; PPO plans probably would not require referral. Most PPO plans you can go to anyone you choose.
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Postby zap » Thu Jun 25, 2009 12:20 pm

Yep, I think you're right - I may not need a referral. I called Angela earlier this afternoon - she is going to check with my ins co and let me know what the damages to my bank account could look like ...

... on one hand, my disability is very low, I am early in the disease, so I could wait and see ... on the other hand - I am early in the disease and my disability is low, so I could get this checked and treated early, before more damages are done ...

I guess I'll wait and see how financially viable it is to help me figure out which way to go. Thanks all for your advice.
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Postby peekaboo » Thu Jun 25, 2009 6:15 pm

Please do not wait for intervention...I am a ppms stanford person and i believe the more "damaged" one is the longer the recovery. go for it...
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Postby zap » Fri Jun 26, 2009 12:43 am

according to someone elsewhere,

both private medical ins and Medicare will not pay for blocked jugular veins, until the blockage reaches 75 percent or more with blockage.

In other words, if the blockage is 60 percent they will not pay for it.


True?
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Postby Arcee » Sat Jun 27, 2009 7:36 am

Coach, just wanted to say that my neuro indeed is interested and supportive about the argument and the testing. He's a bit hesitant about the procedure since there is not yet published data, but in some ways blocked veins become something more than or different from solely an MS issue so it kind of gets beyond his domain. I find him supportive or me personally, and I think he is intrigued and wants to learn more.
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Postby zap » Wed Sep 02, 2009 11:48 am

Turns out that Dr Dake, despite being across the country from me, is In Network on my plan! Awesome!!
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