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im so blessed
03-04-2017, 06:49 AM
So, I live in PA and i have medicaid. I want to get a 2nd opinion at CC. I called 9 days ago. First, before they will schedule me they need to see if my insurance covers. I know it does not, But ok. They will call me when they know. If im not covered, i will pay $900 out of pocket. Wow. Ok. So i have called them 3 times since. Someone is always going to call me as soon as they get the no from my insurance. I have been given 4 different prices now that i will pay out of pocket. Anywhere from $400-$900. And they will still not put me thru to scheduling. I have to pay the full amount ( whatever that is???!!!!) before they will schedule me. Does anyone have advice? They are only 4.5 hours and i really want to go there!!!!

Pete
03-04-2017, 08:17 AM
I'm guessing that your trying to get past the billing department. If you have the number for a specific doctor you want to see, you might want to try calling that office first and try to get their help in pricing and billing.

While CC has a lot of great docs who provide great care, the billing department seems to have issues. If BookNut reads this, perhaps she can offer some guidance...

BookNut
03-04-2017, 08:50 AM
[QUOTE=im so blessed;110401]So, I live in PA and i have medicaid. I want to get a 2nd opinion at CC. I called 9 days ago. First, before they will schedule me they need to see if my insurance covers. I know it does not, But ok. They will call me when they know. If im not covered, i will pay $900 out of pocket. Wow. Ok. So i have called them 3 times since. Someone is always going to call me as soon as they get the no from my insurance. I have been given 4 different prices now that i will pay out of pocket. Anywhere from $400-$900. And they will still not put me thru to scheduling. I have to pay the full amount ( whatever that is???!!!!) before they will schedule me. Does anyone have advice? They are only 4.5 hours and i really want to go there!!!![/QUOTE

Don't know how old you are. Do you qualify for Medicare? We have medicare and also supplemental insurance that covers out of state medical services. It was still a nightmare getting them to honor the medicare negotiated price. We were approved after various maddening hitches. Then when we were done with treatment they were billing us for the difference between the negotiated medicare cost and their official charge which is an illegal billing practice. They ended up sending us to a collection agency. It was a nightmare. I think they finally gave up, not because they admitted they were wrong but because my hubby is a former insurance adjuster and knows all the legal jargon. They knew we were not about to give up. The billing dept is extremely incompetant. I would not have a treatment or appointment there without having a statement in writing of the exact amount due for each treatment. The medical staff is great. Support staff not so much. I made a typo when typing above the phrase "billing dept". It came out "bilking dept". Perhaps I should not have corrected it. The typo might have been closer to the truth. �� Again the medical staff and treatments were great. It is the "bilking dept" you have to watch out for! ��

vdub
03-04-2017, 02:48 PM
I'm guessing that if you are on Medicaid, then CC is assuming you don't have the money to pay for the consult and they want you to pay upfront in order to avoid a "non-payment" later. I think the only thing you can do is keep plugging away for a quote, you might get one, but, if you do, I wouldn't expect it to be fair and reasonable.

However, their reluctance to quote you a price is also normal. Most likely, they don't have an exact actual price for a specific procedure, at least, not a price you would be willing to pay. From what I gather, the medical providers, be it a hospital, doctor, lab, whatever, will have an ultra-high price that they charge the insurance company. That will be the one you see on your bill. And, then, they have an "acceptable" price, which will be the calculated or negotiated "fair" price that the insurance company actually pays. The "fair" price will be much lower than what was billed.

Most of the "fair" prices are different from one insurance company to the next and also different from one provider to the next. Our medical system is one big con game. Medicare is one of the lowest paying. That is why many doctor offices now have signs that say they are no longer accepting new medicare patients. The reason is because the private insurance companies pay more. Normally, providers can balance out the medicare with the better-paying private insurance companies, eat the loss on medicare and still make ends meet. It is the doctor's prerogative to do that -- their is nothing illegal or even immoral about the practice.


when we were done with treatment they were billing us for the difference between the negotiated medicare cost and their official charge which is an illegal billing practice

Booknut, That's not an illegal practice. Many times I have gone to a doc's office and they have asked me to sign an agreement to pay the difference between what they charge and what the insurance company pays. Normally, I just sigh and sign, but several times I have refused. Each time, the receptionist has gone to the billing person and received and ok to proceed without the signature. I suspect they have a legal claim to the difference whether I sign or not. They just want you to sign in order to shortcut any messy legal processes or collection agency.

BookNut
03-04-2017, 03:43 PM
Interesting. Our insurance told us it was not legal for them to do this. Maybe because they had not told us upfront? We were not asked to sign any agreement. We were simply approved for treatment.

Debbie C
03-06-2017, 11:13 PM
I don't know if medicare is different in Pa. as is in Ohio, but when I was on Medicare I had to pay a spenddown to medicare before I wasn't charge at drs. appts and hosp. or scripts.. But my spendown was 900.00. Like was mentioned before ALOT of drs will not see pts on Medicare. I do know that CC offers financial assistance. Like Pete said it might be best to call the drs office directly to make the appt.I am going up there this Wed to see my rheumy at 1:00 if anyone is going to be around there

vdub
03-07-2017, 06:08 AM
I can't remember if I mentioned that I was going to Mayo or not. My memory has really gotten bad. Anyway, I'm going to Mayo for a week of apt's (research?) on 20Mar. Apparently, I'm interesting. I have considered giving my cold dead body to one of the universities, but haven't decided which one.

drz
03-07-2017, 06:58 AM
I can't remember if I mentioned that I was going to Mayo or not. My memory has really gotten bad. Anyway, I'm going to Mayo for a week of apt's (research?) on 20Mar. Apparently, I'm interesting. I have considered giving my cold dead body to one of the universities, but haven't decided which one.

Mayo has a med school so ask them about it when there.

Debbie C
03-07-2017, 11:52 PM
Good luck at Mayo vdub. I wish they could find something that will help you more. Do you remember saying I can have your car once you finished it !!!! :biggrin1:

im so blessed
03-08-2017, 12:32 AM
So i am still waiting for a call. I have called 2 times since my post. I have been very firm with them that when they give me the correct price i will pay it so i can schedule. Someone will call me...just leave a message on her voice mail...yadayadayada....it feels impossible!

vdub
03-08-2017, 03:11 AM
Do you remember saying I can have your car once you finished it !!!! :biggrin1:
I do remember that! :-) I'm hoping it will be a long, long time, and then, of course, the wife has to get her use out of it, and then daughter, etc. It could be a while....

Debbie C
03-08-2017, 12:18 PM
I do remember that! :-) I'm hoping it will be a long, long time, and then, of course, the wife has to get her use out of it, and then daughter, etc. It could be a while....

I also hope its a very long time

im so blessed
03-08-2017, 12:43 PM
Got my appointment...next week already. Pretty excited!

Debbie C
03-09-2017, 02:28 AM
That's great news..which dr. are you seeing ? I am on my way there now. I have been very ill the last few days. STRESSED :(. I hope she doesn't decide to keep me there

im so blessed
03-09-2017, 07:10 AM
I am seeing Dr. Villa Forte. I feel like its christmas :) I have had this disease over half my life, but i've never seen a rhuemy who specializes in wegs. I am starting my list of questions...i have always been a "rare mystery" to local docs. What is it gonna be like to get good, solid, experienced answers to all my questions over the years!!!

Pete
03-09-2017, 07:22 AM
I am seeing Dr. Villa Forte. I feel like its christmas :) I have had this disease over half my life, but i've never seen a rhuemy who specializes in wegs. I am starting my list of questions...i have always been a "rare mystery" to local docs. What is it gonna be like to get good, solid, experienced answers to all my questions over the years!!!

She's great!! Hope she can help you feel better soon!!

vdub
03-09-2017, 07:44 AM
And, what did they finally come with as a cost?

Glad you are getting in to see them. I'm equally as anxious about going to Mayo. They've already sent me a lot of material and so far I have an entire weeks worth of appointments -- and that might extend out longer into the next week. Because the appts might go into a longer period of time, we are driving instead of flying. I thought about taking the RV, but the weather is still kind of iffy and there probably aren't even enough RV parks open along the route. I was ready to take the RV, but my wife brought up all these arguments -- she is smarter than I am. :-)

im so blessed
03-10-2017, 01:30 AM
I had to give them 635$ before they would schedule...hopefully it will feel worth it!

Pete
03-10-2017, 02:46 AM
The price is at least in the lower part of the range they gave you. The best can be pricey!

Before you see Dr Villa Forte, you should write out your history with wegs - symptoms, dates, treatments, and results. Be as specific as you can. My first appointment with her was scheduled for 40 minutes and lasted about twice that. My appointment included history, an examination, and labs (the lab is on the first floor of where Dr Villa Forte's office is).

I think you'll find her to be very thorough, a good listener, and easy to talk to.

Let us know how it goes.

im so blessed
03-10-2017, 02:56 AM
[QUOTE=Pete;110482]The price is at least in the lower part of the range they gave you. The best can be pricey!

Before you see Dr Villa Forte, you should write out your history with wegs - symptoms, dates, treatments, and results. Be as specific as you can. My first appointment with her was scheduled for 40 minutes and lasted about twice that. My appointment included history, an examination, and labs (the lab is on the first floor of where Dr Villa Forte's office is).

Thanks Pete! Did she require you to do labs? even if you have recent copies? as that would be an added expense. My appointment is scheduled for 90 minutes. I am very happy about that, as i am not getting my records sent to her prior the app. Do you have experience with motels in the area? Looks like maybe Holiday Inn is closest. Thanks for your help!

Pete
03-10-2017, 04:36 AM
You may want to contact her office about labs. As I recall, I had the c-ANCA, p-ANCA, and PR-3 there. I may also have had a CBC, CMP, and urinalysis.

There is an Intercontinental Hotel on the Clinic Campus just across the courtyard from her office. I have no experience with the hotels or restaurants there as I can drive the round trip easily within the day.

Debbie C
03-14-2017, 02:14 AM
I always stay at the comfort Inn up there. It is not far from the hosp and they have a shuttle service that will take you and pick you up...you avoid paying the parking toll. Also if you tell them you are going to the CC they will give you a discount. Best to make resv. first. Good luck up there. And like Pete said any med. records you can take up the better.

Debbie C
03-14-2017, 02:55 AM
Now to my recent experience that only has me fuming but again worried. I went to CC last Wed. and my dr ( dr Langford) said I looked the worst she ever saw me. I barely made it walking to her office without just passing out. I was clinching to Jacks arm so I wouldn't fall. ( no wheelchairs) Anyway she wanted to direct admit me but since it was my mothers 90th birthday on Fri. I wanted to be home. Also the hosp I go to here provides me with financial asst. where up there I would be out thousands. So after a half hour of her trying to convince me to stay I promised I would go to the hosp here. BIG MISTAKE !!!! I went to the er ( since they won't direct admit me like up there ) after being in the er half the night I was put in a room with a lady who sounded like she had pneumonia. She said she was in last week and was coughing until after she was released. Anyway Thurs. I just laid in bed and never saw a dr. Fri they finally ordered a ct scan of my chest and brain and later an mri of my brain. The student for the neurologist said he thinks it is my wg UNTIL my pcp ordered a urine test to check for drugs. He came in my room and said how long have you been smoking pot. I told him about the cbd and that's all it took. They were both convinced I was a pot head and that was it. When the neurologist came in with his group of 5 students , he was being a smart ass ( sorry Andrew ) but I asked him about my stabbing headaches and dizziness. He said my sodium was low and I needed to eat a bag of potato chips and that my bp was low.And he said med. pot is nothing but a big hype and it has not been proven good for anything. Needless to say we had words. I had the nurse show me my labs and my sodium was 146,on the high side but in range and she took my bp and it was a little high cuz I was REALLY pissed. So the sob sat there and lied to me because I showed pos for thc. Last night I was on my chart from the hosp and my mri showed I had changes in the small blood vessels in my head probably due to wg. I am looking today for a new pcp and then I am going to call the other drs. office and tell him I didn't appreciate him sitting there lying to me when this disease could be fatal. I also him going to call the medical board and report him. Another person who hasn't seen the wrath of a woman on pred ! Sorry for the long vent but just other prove you MUST be your own health expert.

me2
03-14-2017, 03:37 AM
It is bad enough being sick but to then get jerked around by a doctor is just terrible. I'm sorry you have been put through this.

Jaha
03-14-2017, 10:16 AM
Deb, This was at your local hospital, where this happened? I really hope you get to the bottom of why you were treated so badly. Please try to get yourself taken care of as far as your health goes. You do know that CC has a financial program to help pay for your care also. Let us know how things are going with you.

Debbie C
03-14-2017, 11:37 AM
Im so blessed, I just realized that you started this thread and I kinda hijacked it....sorry. It just seems like something I would start a thread with. Although I love my CC doc, its all the other idiots I have where I live. I will put things on my thread and again good luck up there.

im so blessed
03-14-2017, 10:50 PM
Its just fine! I hope you are feeling better real soon! I'm still so excited about my appointment friday. I will be checking in afterwards.

Jaha
03-15-2017, 04:08 AM
I am wishing you all the best at CC. She is a very good doc and will treat you well.She is very fast,but just reask her if she goes to fast and she will slow it down.

im so blessed
03-19-2017, 12:53 PM
I had a wonderful 2.5 hour visit with Dr. Villa Forte. She was very aggressive in my treatment and going forward plan. Which i am very greatful for, as i have been missing this the last several years. She was also gracious, in that she understands my situation with cost, and is willing to help keep that down however she can,albeit working thru local rheumys or dealing thru phone calls and email. She is VERY convinced and set on it that i HAVE to come back to CC to see ENT. A dr Robert Lorenz. As she feels sure my current treatment for my stenosis is not the right treatment. She also pointed me to a rheumatologist at West Penn..a Dr Michael Lucke. He did 3 years of residency at CC with her and she feels sure he would work with her. So i have to decide what to do. Go to him, and let him ask her for help if he needs it. Even tho he is still a 3 hr drive. Or ask my current Rheumy to work with her. Or see Dr Villa Forte once a year and not have another Rheumy, but do phone calls in between appointments. And i have to decide about going to see the ENT at CC. Anyone have any thoughts? Its so much to think about! Im so glad i have you guys! I wouldnt have ever found her without you all :thumbsup:

drz
03-20-2017, 09:59 AM
These are my thoughts: Generally most people go to where ever they can get the best care for their Wegs or GPA. Many times this involves flying some where or driving for hours to get care from some you can trust and like. Often the financial cost is high but without adequate care the costs or consequences are generally much higher. My trips to Mayo take me three days and six hours of driving each way but feel the costs are well worth it to know I am being seen by one the world's best GPA experts and getting the right care. Poor care is very expensive and can also be fatal or very injurious to your health and many doctors are not competent to manage GPA correctly.

im so blessed
03-20-2017, 11:08 AM
Thanks drz! It can look a bit overwhelming, but you are right. I have to look at the big picture for sure!

Aneinu
04-21-2017, 02:18 PM
I'm glad to hear it finally worked out somewhat in clinic. We actually had decent experience, for the most part, with them.

Dr. Villa forte - we were extremely impressed with. Her concern, passion, knowledge, clarity and patience are just some of her wonderful attributes. You are in good hands with her.

Hope all works out.

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