Dr Dake and Ins

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

Dr Dake and Ins

Postby catfreak » Sat Jul 11, 2009 8:24 pm

I am trying to figure out if Dr Dake is on my insurance plan. Where can I get basic information about him so I can figure this out?

Thanks Cat
Holly - Shine On You Crazy Diamond - Pink Floyd

9/3/09 Stanford - Dr Dake - Stent in R-J to unblock Arachnoid Cyst in Sigmoid Sinus. Stent in narrowed L-J. Balloon in narrowing where R & L Jugulars meet.
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Postby Needled » Sun Jul 12, 2009 4:37 am

Hi Cat, Cheer had posted this earlier in a topic on insurance questions. Angela, Dr. Dake's assistant, now has help. Alexandra seems like the place to start.

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

Good luck!!
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Postby Sharon » Sun Jul 12, 2009 6:43 am

Hi Cat!
As Needled said, call Alex and see if she can help you.
But in the meantime, I will suggest a few things.

If you are on an HMO plan, I would imagine there is a preferred list of doctors (network) and it is probably within a 150 mile radius of your home. Your plan would only cover an emergency outside of the HMO network. Also, you would probably need a referral from your HMO plan. If you are on a PPO plan, you have more options for doctors. Some PPO plans are nationwide and therefore would cover you in Calif. PPO plans you do not need a referral.

Alex will be able to sort through the insurance stuff for you. It might take her a few days ' cause she is only working parttime in the office -- be patient.

Edited - I added this to the post
HMO vs. PPO


Q: What is the difference between an HMO and a PPO? Which one is better?


Answer:
When you're selecting health insurance, choosing the network of health care providers is often the most important decision you'll make. Health maintenance organizations (HMOs) and preferred provider organizations (PPOs) are types of managed health-care systems. And, both offer excellent access to top quality professionals—but it's important to understand the differences before you choose.

In an HMO plan, members must choose a primary care physician from among the HMO member physicians. Your primary care physician oversees all of your general medical care and must be consulted before you can see a specialist, who must also be part of the HMO. If you select a PPO network, you may choose to see either a general practitioner or a medical specialist, such as a dermatologist, without a referral from a primary care physician.

HMOs typically provide no coverage for care received from non-network physicians, unless it's for emergency care provided while traveling away from your home area. In contrast, PPO members are not required to stay within the PPO network, but there is usually a strong financial incentive to do so. For example, the PPO may reimburse 90 percent of costs for care received within the network, but only 50 or 70 percent of costs for non-network care. Unless you have a strong preference for a particular doctor, it's best to stay within your PPO network, because your PPO doctor can also refer you to a PPO surgeon if you need hospital care or surgery.

A key benefit of choosing an HMO is the fact that you do not have an individual or family deductible to meet. Instead, HMO members generally pay a nominal co-payment for each visit, including a hospital stay. In contrast, PPOs sometimes require members to meet a deductible, especially for hospitalization, and may have larger co-payments than HMOs.



Hope this helps
Sharon
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Postby catfreak » Sun Jul 12, 2009 12:11 pm

Thanks Needled and Sharon!

I have a PPO and I find all these Dr in the Stanford area but not Dr Dake. It drives me crazy because I should be able to enter his name and find him but, his name is just not there. I knew I read the post somewhere with the info.

She can tell me if he is a P provider in my network? I have a $3000 deductible and once I meet it it pays at 100%. I have long met that with the Tysabri infusions. So I'm thinking why not???

Thanks again

Cat
Holly - Shine On You Crazy Diamond - Pink Floyd

9/3/09 Stanford - Dr Dake - Stent in R-J to unblock Arachnoid Cyst in Sigmoid Sinus. Stent in narrowed L-J. Balloon in narrowing where R & L Jugulars meet.
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Postby peekaboo » Sun Jul 12, 2009 1:41 pm

Why Not? You go girl....
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Postby Needled » Tue Jul 14, 2009 5:37 am

Cat, You said last night in a post to Lew on his test results:
Cat (who's thinking about making that call too)

I don't see any harm in making a call. You're just gathering more information to make an informed decision. You're not comitting to anything. Pick up that phone!
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Postby chrishasms » Tue Jul 14, 2009 7:18 am

123
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