This Is MS Multiple Sclerosis Community: Knowledge & Support

Can you tell me where who and how much this testing and procedure cost, and or is covered by insurance

thank you for any and all information

rethink [/b]

read the posts. it s more than a quick fix in this.

I have read comments from many people and no where is it stated what the cost is. if you could just address that part it would be great. thanks

This is the info I got from Dr. Simka when I got my confirmation for being on the waiting list:

Current (January 2010) offer for patients suffering from MS:
-vascular specialist consultation with non invasive diagnostic procedure (color doppler and MRV)
300 euro

-vascular specialist consultation with non- and invasive diagnostic procedures (angiography)
1100 euro

-vascular specialist consultation, all necessary examinations and an endovacular procedure (PTA)
3500 euro

-vascular specialist consultation, all necessary examinations and an endovascular procedure
(1 stent implantation)
4200 euro

-vascular specialist consultation, all necessary examination and an endovascular procedure (2 stents implantation)
4700 euro

You can do the currency conversion here: http://www.xe.com/ucc/

Hope that helps....

I read that Dr. Dake in San fran was charging 90,000US but that insurance covered it - or most of it for many of the people who had the procedure last fall.

120,000 out the door, including follow up. Got the bill in my hand. Well not now cause I'm typing, but you know what I mean

The insurance write down (cost of procedure vs what my insurance thru BCBS is contractually obligated to pay and not a dime more, was over 75K. My insurance cut them checks totaling 38k. "Other adjustments" was 4k, my take is 2k out the door, with a 90/10 plan for the hospital. Then I applied for aid thru finance assist, because we are feasting on dirt pies right now, their lower income limits are generously high, so we didn't get penalized for my wife working and qual'd for 100% which just about gave me a heart attack from shock. Usually it's federal poverty level guidlines that warrant financial assistance, not the working poor, so very very glad, and thankful for that. Guess we'll keep the dog now. She only eats a little bit, and her name is Fajita. (OT!)

The irony of the final bill, and the letter granting financial assistance, both in the mailbox on the same day is not lost on this person.....

M.

_________________
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap

Well, shoot. Now I'm confused with the actual cost. My estimate to have it done in Poland is much lower...

As well it should be, they don't call it "medical tourism" for nothing!

Mind you, I doubt anyone in their right mind would pay 120,000 cash for all this, unless they are wealthy and want it *now*, even then cash prices are easily negotiated downwards.

Look at it this way, Stanford got a check cut for op services, 1 MRI, and a bed for one night, and the associated stents, doctors,nurses (they alone are worth the 38k), so on so forth, they aint going broke any time soon on that. Like my MS meds, they wanted some OUTRAGEOUS number for them, like 4k a month, I know, sounds ridiculous, but that's the game that is played all around. My insurance calls them, they "negotiate" and end up "settling" for exactly the going rate for the drugs, back then it was like 1900 and change, then I get whacked for the delivery fee and assorted other stuff for 100 bucks a month, nobody is losing their shirt, guaranteed.

8k a stent, times four, is 32,000 for the stents sitting on the shelf all by themselves. They could charge 500,000 for the stents, doesn't matter, when the insurance has a contract with BC/BS, and Stanford is a contract hospital, it all gets into write offs, i.e. they "lost" a ton of money on the operation. The fair market value was 120,000 (inc. follow up!), they got paid 40k, they lost 80k, voila, tax deduction.

Everyone is happy, because a lot of it is just a numbers game, plain and simple. The secret is to absolutely without question stay within your PPO network if you have one, and if HMO it doesn't really matter then.

In Poland and other countries they don't have such onerous issues, the cost of living is lower, and cold hard cash goes much further than it would here...

Mark.

_________________
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap

http://www.youtube.com/user/MoneyTalksN ... tKzB57AxxE
http://www.youtube.com/user/MoneyTalksN ... CyOrMLovFA

Thanks for the clarification! I guess I never expected my insurance company to pay to have it done in the US (or anywhere) anyway. I guess that's why I was so shocked at the cost.

That's what I said but they did! They have a contract for instance with LabONe, where I went to get blood draws for the INR readings post procedure, their final payout to Lab One, PER draw, was like 7 bucks. I don't know how they can possibly even cover the overhead with that. My insurance is very very cheap in what they pay out, but contract is contract so I don't worry about it, they are very solvent, and in fact (sit down everyone!) lowered our COBRA this year to 606 from 639. Yes, they actually LOWERED what we pay for COBRA. They are so solvent in fact, they are loaning money to the retirement fund to bolster it, following the losses in the equity markets over the past few years.

When I first started actually USING my insurance a few years ago (never got sick, just minor stuff I paid cash for usually since it was less than my deductible), it was a big time learning curve on how things really work. Some lessons learned the hard way of course. Heck just finding a specialty pharmacy to get my meds was a battle of epic proportions. Then my insurance switched to BC/BS network, and life got a bit easier, funny part is, all the $$ part, payouts, all that, exactly the same, just got a pretty BC/BS card that offices instantly recognize.

Mark

_________________
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap

Mark, my last COBRA was a little over $600/mo too back in the Bay Area before we moved to Portland this past September. Though my OMIP insurance is $345/month, my out of pockets costs are much higher due to the detectable and % of services I pay. I would be on cloud nine if they at least paid for SOME of the procedure for me!

thank you for the information, does anyone take insurance? or do pay and then bill your insurance. Has anyone gone to Poland for the procedure.

I was on the internet the other night and read something about a new treatment using goat serum and seeing outstanding results . So many thing and yo just don't know what avenue to go after. Once again thanks for the information on the cost for the ccsvi.

oh, by the way has anyone gone thru the procedure without a MRI. I can't have a MRI due to a clip in the head area, thanks for any information you can give me

Please remember (and this is especially for our non-US members) that this is the cost that gets billed to insurance, no one pays that much. In the US they play a game where insurance companies are billed very large costs, but then they pay the approved rate. I have seen doctor bills for $500 where my insurance pays the doctor $50 and he is happy. Any doctors/hospitals who participate in an insurance companys plan has to agree up front to accept the negotiated rate.

This $90,000 number was one of the pieces of propaganda that the neuros were using to put CCSVI down. I had a doctor tell me he couldn't believe what people were paying to see Dr. Dake, that he was ripping them off. I then explained where that number came from, I even mentioned how much does he bill but then accept, and he was quiet.