First Post-Insurance Issues US

SherrieT

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Of all times for my knee issues to come up, it was on trip of a lifetime to London. Got back to US and find out I have bone to bone on right knee, not much better on left. Arthritis, and I had no idea.
Because of insurance issues I have to have services (because both knees will be need to be done soon) after beginning of year 2018. Ended up that the first surgeon I went to was NOT in-network with insurance (he opened new service but still showed up as his old service address) . I now have another appointment with an in-network surgeon Dec 19th.
I'm so glad I found this site. It is so depressing having to deal with all the pain but, hopefully, the light at the end of the tunnel is not an oncoming train!!
Won't have much more info until new surgeon appt but do want to find out from him how soon after first TKP will he do 2nd knee.
I'm lucky in that I am able to sleep at night, in the right position. But I just want to start having to deal with surgery pain and not the arthritic pain!!
 
Awww, Sherrie....I'm so sorry all this happened on your trip of a lifetime!! I hope even with knee pain it was still memorable for you.

Good for you for paying attention to the rules of your insurance. Sadly we are somewhat governed by our policies, but I'm sure you'll be able to find a good surgeon in network. If you have any questions about the process or potential surgeons, feel free to post them here and we'll help you work through any issues. You're part of our BoneSmart family now, so please know we'll be right here if you need us.

We've had thousands of BoneSmarties go through that same tunnel and not one ever was hit by a train! :heehee: (A little "bone" humor)

Do some reading on the threads and in our BoneSmart Library to get started. And don't hesitate to ask any questions that may come up.
 
I had issues with insurance that held up my surgery for a few months earlier this year but it eventually got sorted. I spoke with three different surgeons with each having a different way of doing things. One choice I was offered was a conventional Stryker implant with computer assisted surgery, one was a quad sparing surgery with side incision with a "sports" knee, and one was the custom conformis knee, 3d printed from a scan of the knee. I'm sure there are even more possibilities out there. I'm glad I did the research. Until I had insurance issue, I was simply going with the orthopedist I had been seeing for the last few years. I ended up chosing a well regarded surgeon with the custom conformis knee and had surgery in July of this year and am pretty happy with the outcome.

Regarding how long you need to wait between surgeries, there is a wide range of possibilities depending on your health and on your surgeons philosophy. Some people get both done at the same time, a bilateral. Some get staged surgeries only a few days apart in the same hospital stay. Many surgeons require a 6 -10 week wait between surgeries. Some options may not be possible for you based on health or the medical issues involved but some surgeons are pretty rigid about what they will or wont do. However, another surgeon may offer you a different option. It pays to check around, do research and ask questions. You are on the right site to read others experiences with two surgeries and see the advantages and problems with different spacing of the two surgeries. Good luck!
 
@Jamie and @Jajakio, thank you for your responses.This is frustrating! The surgeon I have an appointment with Dec 19th is in network but the hospital he operates at isn’t.
I’ve decided no more messing around with this. Called Brigham and Women’s Hospital in Boston and will be talking to patient coordinator. Almost all of the orthopedic surgeons in their ortho department are in-network as is the hospital itself. Hopefully next week I will have more info on their surgeons and be able to make informed decision
 
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I like your new plan for making sure you have both hospital and surgeon in your insurance network. Make sure this hospital has a good rating for orthopedic surgery, and then check the ratings of the different surgeons. The goal is to get the best hospital and surgeon you are able to get.

Also consider asking about bilateral knee replacements. One surgery, one recovery. Some surgeons will not do them, or will do them only if the patient qualifies for health and situational reasons (help at home, stairs, access to services, etc.). I had two horrible knees and was very happy to have mine done at the same time. They're also nicely recovered at the same time! :egypdance: But like I said, it's about what's best for you, and what your surgeon recommends. Find out all your options and you will make the best decision for you.
 
@SusieShoes - One of my requirements for a surgeon is that he/she would be open to a bilateral or a staged with short time between surgeries. Thank you for your response
 

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