How much did it cost?

The final frontier. Deciding when, if and how.
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SteveSW
Posts: 977
Joined: Sat Sep 08, 2018 6:23 pm
Location: St. Louis, MO

Re: How much did it cost?

Postby SteveSW » Mon Nov 21, 2022 8:33 pm

Between Medicare and my supplemental United Healthcare plan, the bills were paid quickly and without question. Until...a year after surgery I got a $1,500 bill from the hospital. It was for a myriad of incidental services, tests and people I had no knowledge of. I sent the bill to Medicare and United, and neither had ever received the bill. The hospital kept saying, multiple times that they submitted the bills, but Medicare and United said they never got them. United was very helpful. went through the claim item by item and had nothing. I fought it for months; the hospital turned me over to collections and I gave up and paid the bill. Insurance would have covered it, had they ever received them!
20 years of severe Peyronie's plaque, 90 curve, hinging and ED. Cost me 1.5" L and 1" G.
Implanted 2/18/21, AMS CX, 18 CM + 3 RTE, penoscrotal. Have gained 3/4". Gay, married, age 68.

jdsatx
Posts: 2
Joined: Mon Oct 24, 2022 3:45 pm
Location: Texas

Re: How much did it cost?

Postby jdsatx » Mon Jan 23, 2023 3:45 pm

Daytripper wrote:Yea BCBS denying coverage was a big surprise, turns out it an exclusion to my policy, their pamplet reads: "Any servicers or supplies provided for, in preparation for, or in conjunction with sexual dysfunctions" . My Doctors appeal for a peer to peer review went no where because the procedures an exclusion vs appealing for whether or not it was medically necessary.

Didnt have this problem for the initial implant because I had different insurance at the time, it was Aetna and all I had to pay was $1,500 deductable.


Alright. I have to ask how you were able to get Aetna to pay for the procedure? I was speaking to Dr. Clavell the other day and he mentioned that Aetna would not cover the implant/procedure. My plan was provided by my employer, USAA. And reading all the literature, I could find other sites it states that they should be able to cover that, but I’m not for certain what the deal is with those folks.

Daytripper
Posts: 77
Joined: Sat Nov 05, 2022 9:42 am
Location: San Antonio, TX

Re: How much did it cost?

Postby Daytripper » Mon Jan 23, 2023 4:43 pm

Well my original implant was in 2012 and back then Aetna covered it without any hassles. Now in 2022-23 it seems like more and more insurance companies are listing it as an exclusion to keep their cost down and employers premiums down.

The lesson I learned for next enrollment period is to ask for each plans list of exclusions before making a choice, I see now that an exclusion in my case is more important than the deductable, copays or office visit cost because the exclusion has a serious drain on out of pocket cost. Also I'm researching if a supplmental plan be added in case another revision is required. GL.
Last edited by Daytripper on Mon Jan 23, 2023 7:02 pm, edited 1 time in total.
62 yrs old first implanted 9/4/2012 Titan OTR, lasted 10 years failed on 9/7/2022. Revision by Dr. Clavell 4/5/2023. 24cm + 1cm RTE's, Titan OTR. 110CC cloverleaf reservoir. Penoscrotal both times.

Livingstonguy
Posts: 104
Joined: Mon Sep 26, 2022 8:18 am
Location: Livingston, TN

Re: How much did it cost?

Postby Livingstonguy » Mon Jan 23, 2023 5:20 pm

Funny that BCBS was mentioned. I had my surgery 12/22/22. I have a letter from BCBS saying my surgery was covered 100% (- deductible). The letter also said I should call again before my surgery to make sure nothing had changed, which I did 2 days before my surgery. They said I was good to go.

During recovery at home I get an EOB letter from BCBS saying they paid the anesthesiologist nothing and that I owe $2200 for anesthesia. None of the other charges have been submitted yet. When I called BCBS to ask WTF, they said ED surgery wasn't covered. I told them I had the letter in front of me from them saying i was covered. Now it's "under review" and I'm supposed to hear something in 7 - 15 business days. Still waiting.

Anyone know the name of a good lawyer? lol
Implanted 12/22/2022 AMS 700cx 21cm with 1 cm RTE at St Thomas midtown in Nashville
Livingston, TN (BFE)
Contact:gregandkelly63@hotmail.com
60 years old Prostate cancer at 58 with RP at Vanderbilt

Married 40 years to my best friend

TurnBackTime
Posts: 44
Joined: Sun Jan 22, 2023 9:46 am

Re: How much did it cost?

Postby TurnBackTime » Mon Jan 23, 2023 6:35 pm

I wasn't going to post to this thread, but I figure that you all might benefit from the jaw dropping image I have attached to this post. That image shows the original amount of the hospital bill (only the hospital bill, not all the other bills that go along with the operation) .
hospbill.JPG
hospbill.JPG (50.28 KiB) Viewed 248 times
Just Trying To,
Turn Back Time

Daytripper
Posts: 77
Joined: Sat Nov 05, 2022 9:42 am
Location: San Antonio, TX

Re: How much did it cost?

Postby Daytripper » Mon Jan 23, 2023 7:09 pm

TurnBackTime wrote:I wasn't going to post to this thread, but I figure that you all might benefit from the jaw dropping image I have attached to this post. That image shows the original amount of the hospital bill (only the hospital bill, not all the other bills that go along with the operation) .
hospbill.JPG
Thats crazy, looks like the hospital inflates their rates as a standard billing practice and then makes adjustments only when called on it. From $244k billed to settling for $18K. Is this practice legal?
Btw congrats on your out of pocket bill, looks like you hit the insurance lottery.
62 yrs old first implanted 9/4/2012 Titan OTR, lasted 10 years failed on 9/7/2022. Revision by Dr. Clavell 4/5/2023. 24cm + 1cm RTE's, Titan OTR. 110CC cloverleaf reservoir. Penoscrotal both times.

Tokyo_123
Posts: 254
Joined: Tue Mar 01, 2022 3:02 am

Re: How much did it cost?

Postby Tokyo_123 » Tue Jan 24, 2023 3:45 am

Daytripper wrote:
TurnBackTime wrote:From $244k billed to settling for $18K. Is this practice legal?
Btw congrats on your out of pocket bill, looks like you hit the insurance lottery.


I paid cash around $18,000. Read on this forum that some with insurance are charged $150,000 and up. Can someone there please explain this, or is it just straight theft??
Venous Leakage (which I believe caused by my overuse of the Bathmate VED)

Dr. Clavell, August, 2022. Titan One-Touch, 24cm XL cylinders and trimmed off 0.5cm

advaita
Posts: 53
Joined: Fri Nov 26, 2021 1:25 am
Location: France

Re: How much did it cost?

Postby advaita » Tue Jan 24, 2023 5:04 am

Hello,
Everything was taken care of by the French health cover.
I only paid for the additional fees of the surgeon and the anesthetist, and the supplement for a single room in the clinic.
So a total of 1100 euros.
France - 67 - implanted: November 2021 - AMS 700 CX

Old Guy
Posts: 2474
Joined: Tue Mar 31, 2020 4:31 pm
Location: Ohio

Re: How much did it cost?

Postby Old Guy » Tue Jan 24, 2023 9:57 am

My deductible was around $3,400 with UHC, and another $500 for the doc fee. Couple months later they sent a refund of about $550.

My advice is fight insurance if they deny any payment. Usually, an appeal will make them change their minds.
Did you know initial insurance reviews are normally done by non-medical people? They have a list of buzz words to look for under each CPT code and either approve or deny. On an appeal medical folks review it.
Nov. 8, 2019
4+ years, Coloplast Titan OTR
Married 36 years to my beautiful young bride
Always here to answer questions if you PM me

ThailandBound
Posts: 951
Joined: Fri Dec 16, 2022 5:32 pm

Re: How much did it cost?

Postby ThailandBound » Tue Jan 24, 2023 10:28 am

Tokyo_123 wrote:
Daytripper wrote:
TurnBackTime wrote:From $244k billed to settling for $18K. Is this practice legal?
Btw congrats on your out of pocket bill, looks like you hit the insurance lottery.


I paid cash around $18,000. Read on this forum that some with insurance are charged $150,000 and up. Can someone there please explain this, or is it just straight theft??


You got a deal it seems. On my initial video consultation with Dr. Clavell he seemed a bit uncertain to actual cost. “About $23,000” he said. Then when i began to firm things up (no pun intended) with the surgical coordinator she said “21,000”.

And that’s what i paid. $21,000.

Less than the price of a mid-range sedan, only i’m certain that the “new” will never rub off.
Active, athletic 63 years old. Sexually, still 33 in my mind and spirit. Pills and injections all worked, until they didn’t. Diagnosed with veinous leakage in 2022. Coloplast Titan. 22 CM. No RTE. Peno-scrotal. Implanted 1/4/23. Dr. Clavell.


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