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  1. #1
    Join Date
    Jun 2004
    Location
    the backcountry
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    3,500

    Quick knee surgery question.

    So I’ve needed a new acl for quite sometime and I’m finally ready to do it.

    I have medical insurance through my work and I met with a surgeon over a year ago. After getting confirmation that I needed surgery we set a tentative surgery date for 3months out. When three months came…I discovered that the surgeon had left the provider.

    I went to see another doc and started the process over. We set a tentative surgery date for this September and all was good. I just called to finalize the date and now I’ve learned that he is also leaving the provider. WTF! Back to where I started…no doc, no date, and lots of reservations about using this provider.

    My quick question is…

    If I want to just choose a reputable knee surgeon that is outside my network and pay for it out of my own pocket…what should I expect it to cost? I need a full acl reconstruction and I’ll most likely go with a patella graph.

    3k, 5k….etc?

    thanks in advance.
    so many mountains...so little time

    www.splitboard.com

  2. #2
    Join Date
    Oct 2003
    Posts
    8,887
    Which network?
    Elvis has left the building

  3. #3
    Join Date
    Dec 2004
    Location
    DePere Wisconsin
    Posts
    29
    Are you covered under an HMO or PPO?

  4. #4
    Join Date
    Jun 2004
    Location
    the backcountry
    Posts
    3,500
    Kaiser, HMO

    I can only change to a PPO annually (in Dec).

    That is a valid option so I can pick my surgeon and it would be worth the added costs of having a PPO.

    The downside is that it would mean I would have to put off the surgery for another season, or most of it.
    so many mountains...so little time

    www.splitboard.com

  5. #5
    Join Date
    Oct 2003
    Location
    gone north, but still on the west side
    Posts
    1,676
    I've heard good things about this guy at Kaiser - prolly pretty booked - 6 month wait - but maybe worth it . . .

    Outta pocket - my bills pre-insurance are about 15k . . .

    Edit: you may also ask to be put on a cancellation list. Or you can start a grievance with Kaiser - they have to investigate and you can demand a sooner operation based on the inconsistency with doctors. I've been dealing with Kaiser a bit lately myself and have learned a few thigns - PM or call if you want to chat about it more.
    Last edited by Kellie; 06-21-2005 at 09:05 PM.

  6. #6
    Join Date
    Oct 2003
    Posts
    1,412
    cost for my operation is over 20,000. make certain you know exactly what your insurance will pay before you make commitments with docs, or surgery center it takes some patience but they will give you quotes/estimates that you can compare.
    what's so funny about peace, love, and understanding?

  7. #7
    Join Date
    Oct 2003
    Location
    Seattle
    Posts
    1,341
    Quote Originally Posted by up an down
    cost for my operation is over 20,000. make certain you know exactly what your insurance will pay before you make commitments with docs, or surgery center it takes some patience but they will give you quotes/estimates that you can compare.

    This sounds about right. The brace alone costs about 800 retail, ice machine rental was 450, immobilizer was 90. Make sure your PT person is on a plan, that costs around 200-250 without insurance (insurance pays the company 160ish and I don't pay a dime).

    B)

  8. #8
    Join Date
    Jun 2004
    Location
    the backcountry
    Posts
    3,500
    Thanks all!

    I’m gonna stay on top of this so I don’t put it off another year. You’ll see more of me in this forum (I have lots of questions )

    Thanks again.
    so many mountains...so little time

    www.splitboard.com

  9. #9
    Join Date
    Jun 2004
    Location
    the backcountry
    Posts
    3,500
    Holy shit kellie!

    I just had time to click on your link…guess what? That is the same doc I wanted to use. I’m going to call asap to see if I can get in before he leaves.
    so many mountains...so little time

    www.splitboard.com

  10. #10
    Join Date
    Oct 2003
    Location
    gone north, but still on the west side
    Posts
    1,676
    Not sure how much you've dealt with Kaiser, but all I can say is DEMAND that they give you an appointment, and be the squeakiest wheel you can. Hopefully it will work out. Too bad that guy's leaving, although I suppose it really doesn't surprise me.

  11. #11
    Join Date
    Jun 2004
    Location
    the backcountry
    Posts
    3,500
    I'm in!

    July 25th.

    Now I'm excited and scared...
    so many mountains...so little time

    www.splitboard.com

  12. #12
    Join Date
    Oct 2003
    Location
    gone north, but still on the west side
    Posts
    1,676
    Congrats! Quick turnaround . . . you'll do fine and you've got plenty of resources/support right here!

    Van Den Boegard?

  13. #13
    Join Date
    Oct 2001
    Posts
    7,628
    Quote Originally Posted by bcrider
    I'm in!

    July 25th.

    Now I'm excited and scared...

    FKNA man...just saw this thread. Best of luck to you bro....You'll be back in no time killing it. We'll have to hook up next spring for some turns finally when you're ready.

    And for my 2 pesos of advice: Get a road bike and ride that sucker religiously. The flat American River Bike Trail is the perfect place to log in lots of miles for a rehabbing knee. And I'd be happy to "rehab ride" with ya anytime.
    Waste your time, read my crap, at:
    One Gear, Two Planks

  14. #14
    Join Date
    Jun 2004
    Location
    the backcountry
    Posts
    3,500
    Kellie,
    Yep, VdB.

    I’m stoked he worked me in before he leaves. He initially wanted me on 7/11 which is just tooo soon. I need some time to prepare for this…(mentally mainly)…so f’ing scared. Thanks for the support…I’ll be back with more questions soon.

    Ty,
    Thanks man. I’ll have to settle for the stationary bike I have now but maybe I could sell the wife on a new road bike for rehab too. Sounds good on the spring time turns too!
    so many mountains...so little time

    www.splitboard.com

  15. #15
    Join Date
    Oct 2003
    Location
    Sandy
    Posts
    14,040
    Good luck Chris, you will be gittin it done in no time!
    "boobs just make the world better really" - Woodsy

  16. #16
    Join Date
    Jun 2004
    Location
    the backcountry
    Posts
    3,500
    I had surgery yesterday and all went well.

    The doc said the knee and meniscus looked good (which is surprising after using it for so long without an ACL). Lots of pain and swelling today.

    I cant wait to start rehab so I can get after it (skiing) again.
    so many mountains...so little time

    www.splitboard.com

  17. #17
    Join Date
    Oct 2003
    Location
    gone north, but still on the west side
    Posts
    1,676
    Welcome to "the other side" - glad to have ya in the club!

    Keep it iced and in the air, pump those calves, and keep us posted on the recovery

    Does this mean we'll see you on a chairlift this season?

  18. #18
    Join Date
    Jun 2004
    Location
    the backcountry
    Posts
    3,500
    thanks kellie!

    Quote Originally Posted by Kellie
    Does this mean we'll see you on a chairlift this season?
    NEVER!
    so many mountains...so little time

    www.splitboard.com

  19. #19
    Join Date
    Jan 2005
    Location
    Camden, innit?
    Posts
    2,178
    'bout 6 or 7 months into rehab, I found skinning to be v good exercise. as it turned out, skiing down in boot deep slush was a bit worrying though

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