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Old 05-21-2009, 09:38 PM
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steve55 steve55 is offline
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Join Date: Jan 2009
Location: Dallas, TX
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Default Update

Ill see what Dr peloza thinks. I think the Cervical isnt nearly as dangerous as the lumbar, and its pretty easily accessible.

In the meantime, Mark got back with me. He says Dr B is going to call Dr Peloza ahead of time and update him before I meet with him. So, thats nice he is is trying to do whatever he can to help out. Regarding the price issue, Mark made a good point. How many doctors in the USA or anywhere for that matter offer to do FREE revisions if it doesnt work out? None! Just Stenum only. So, that is something to consider before passing judgement on the price quote situation.

Ive spoken to another Humana rep and she also re affirmed that if my disc is tilting/slipping and there is clear medical necessity to fix it, they will cover it. They wont care that the artificial disc was something they dont cover in the first place. This means I can go out of network with only a $6,000 deductible, and then I pay 30% of their reasonable and alllowable rate. That 30% is likely to kill me if done here in the US. Who knows how high it may go to. However, with Dr B, their prices are so cheap compared to here, Im only going to pay the $6,000 + 30% ($3,600) of the 12K remaining balance, which totals $9,600.

Surprisingly enough, Mark did say that Dr Regan will likely do the surgery at some minimal agreed upon total cost. I think that his getting my $6K deductible plus 70% of the Humana allowables, (and letting me off the hook for the other 30%) he should be good to go. This is the feeling I got from my talk with Mark, if I understood him right.

So, in a nutshell, if Dr Peloza isnt willing to do this at the same rate as Dr B & Dr Regan, then Ill have to decide between the other two. Im inclined to stay in the US though.

Either way, I agree, I have to get this taken care of. My shoulder pain is now EXCRUTIATING! But the pain pills do a really good job of knowcking it out.
__________________
2/26/09 - c4-c7 3 level ADR Prodisc Nova with Dr Bertagnoli. 100% success.

9/22/09 -Dr B opened me up to find a staph infection was eating my vertebrae causing ADR subsidence. Had to remove all 3 ADR's and convert to 3 level fusion. Mostly pain free 2 weeks post op.

9/20/10 - I think I jinxed myself. As soon as I told dr b and dr Sullivan I was doing well (on 6/1/10) I tanked and have experienced the return of pain. My neuro says the new pain is at t4.
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