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» LymeNet Flash » Questions and Discussion » Medical Questions » my llmd no longer takes any insurance!!!

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Author Topic: my llmd no longer takes any insurance!!!
randibear
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i am posting this here in the hope that many more of you will see this than in the other sections.

i go to a llmd in denton, texas, the only one in this area. i really liked him and he took bc/bs.

imagine my surprise when i got a letter today saying he was cancelling all insurance contracts. he still wants to do lyme patients, but is doing them full time. he was an ob/gyn.

the rates are first evaluation $400, follow ups are 195 for 30 minutes, 150 for phone consultss.

guys, i can't afford this. i'm sorry but even with visits every 3 months, it's going to be a strain.

i just want to let you all know that this doctor will not be taking ANY INSURANCE AT ALL..

i don't know what many of you will do.

i'm devastated....totally devastated....

--------------------
do not look back when the only course is forward

Posts: 12262 | From texas | Registered: Mar 2007  |  IP: Logged | Report this post to a Moderator
Leelee
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My first LLMD appointment is next week (thank goodness!), and like yours he does not take any insurance.

I am kind of used to that here, though. A lot of my doctors require payment up-front and then I have to try (really, really try) to get reimbursed from the insurance company.

Sorry to hear of your turn of events. It can really be a burden, I know from experience. [shake]

--------------------
The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy. Martin Luther King,Jr

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emh2l
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I saw a different LLMD. His first visit was $750, follow-ups $350. Even if I wanted to follow his advice/be a patient, I couldn't afford it. What's the point of getting better if you are only going to stress to death over the family finances afterward?
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MY3BOYS
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just to clarrify...i called dr w office, and

this is only tenitive, they have been getting

lot of calls. IF this occurs will be 60-90 days out of mim.

our appt this mo. are not in jepordy

now, i have been active pt for 7 mo and have
been very consistant and have not missed any appt

side note, i also wanted to thank him for referral to pain doc that was great, and confirm our appt this mo (i only put 1 time and me and hubby both, his first appt for work up?? lyme brain.. [loco] )

now,as most of us know,there has been issues with many doc and ins, co
due to the "standard of care" policy, this may end up affecting another LLMD, i am gonna pray strongly it does not

i happen to test CDC positive, so i do not know
if this will be important or not- this means my ins has not had issue iwth any tx so far - to include port and IV rocehin

--------------------
i am not a Dr. any info is only for education, suggestion or to think/research. please do not mis-intuprest as diagnostic or prescriptive, only trying to help. **

dx in 08:lyme, rmsf, bart, babs, and m.pneumonia.

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bettyg
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my3boys,

please clarify what you said about calling dr. w's office ... sorry, but it does not make sense 100%.

please try to rephrase it since i send people llmd info and i want to make sure i have 100% complete accuracy.

thanks 3!

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randibear
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i received that letter today so how "tentative" is it? it did not mention in the future or anything about new patients.

it did not mention dates.

the letter specifically said no more insurance...

what's up?

betty, as far as i'm concerned it's a done deal...i mean sending out letters saying you are doing it is very specific....

--------------------
do not look back when the only course is forward

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Keebler
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-

If you are far enough along in treatment, perhaps what your doctor has taught you will help you be able to manage with very short consults further apart?


What would he require for the writing of scripts (I don't know how much can be done by phone in that regard)?


Might he recommend any good reading for you so that you can better learn how to manage more on your own?


Might he have any other recommendations for LF doctors?


-

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bettyg
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randi, do you know which 3 days a week he works now? tell me please...thanks.
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randibear
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i'm not sure really, he told me last month that he was taking lyme patients only three days a month.

now the letter said he was doing lyme patients "full time" which to me means 5 days a week, 8 hours a day.

tell you what, i'll call tomorrow and get specifics on everything and let ya know.

--------------------
do not look back when the only course is forward

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TerryK
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You can bill your own insurance company. That's what I do. They will pay less if he is out of network. It depends on the type of insurance that you have but if it is a PPO, you will get paid out of network which is usually a percentage of usual and customary charges for the type of service that you are getting. You pay the doctor cash and then bill your insurance company and get part of it back.

Call your insurance company and find out the particulars.

I know exactly how you feel randibear. It's hard to manage all the expenses but what are the choices?? I hope you can get some of the money back from appointments and continue with this doctor.

Terry

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lpkayak
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at 400 it will be cheap enough for many to fly in...in the North East they cost 700-800 to walk in the dorr. testing can be 1000 more easy.

some ins will pick up some of it

but it isn't easy

--------------------
Lyme? Its complicated. Educate yourself.

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sick
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With so many of us not able to work how do they expect us to pay.

sick

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Lymetoo
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Check with your insurance company. My LLMD takes no insurance, but my ins co pays 40% of all visits with an out of network doctor.

There is hope! Call your ins!!!

--------------------
--Lymetutu--
Opinions, not medical advice!

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randibear
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checked bc/bs and they only pay 20 percent. maybe i can save up enough in 3 months for each visit.

i did have to cancel one appointment but gave them plenty of notice.

that's when i was sooooo sick with this flu crap. i had it for 3 weeks. no way i could make that appointment.

hmmm, i'm assuming that he sent the letter to all patients, and not just me....surely not....

--------------------
do not look back when the only course is forward

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Lymetoo
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Check Seeking a Doctor .. info there

It would be great if he would relax the every 3 months rule. That's a bit much for some people.

--------------------
--Lymetutu--
Opinions, not medical advice!

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pab
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Randi,

It probably doesn't mean your insurance won't pay for the visits. You will have to pay at the time of the visit. Then, submit the bill to your insurance company.

We go to a great LLMD. We have always had to pay at the time of the appointment and submit the bill to our insurance company.

Unfortunately, our insurance out-of-network deductible was increased to $6000/person this year. So we pay for all of our LLMD visits for the 4 of us.

I would call your LLMD's office tomorrow. Hopefully it will all work out for you.

--------------------
Peggy

~ ~ Hope is a powerful medicine. ~ ~

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METALLlC BLUE
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I updated my data for this doctor. I'm still waiting for further information.

--------------------
I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.

E-mail: [email protected]

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Just Julie
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This is not new news. Back in the day, starting in May 2000, my LLMD (famous SF one) was taking insurance. Within a year, this would be 2001, he stopped taking ALL insurance. Yes, this was 8-9 years ago folks. It was shocking, I felt betrayed, and politics was not even close to what it is now, insurance and all.

This is only one factor in my dread with my teen son deciding to go to Europe this summer on vacation. I KNOW what a possible rebite, reinfection, relapse could mean, if not for his health, then for the money issues that this could cause. We could go bankrupt. He is 19, still living at home, but works full time. His savings that he has from 2 years of working, and living at home with most expenses paid, would be depleted within 4 months, if not sooner, if he had to go back to our LLMD in SF, and pay for his treatment.

It's just not even an option. This issue goes beyond just folks who are sick now, it's for the future, and as far as I can see, forever.

I'm so sorry randibear.

[ 03-12-2009, 12:22 AM: Message edited by: Just Julie ]

--------------------
Julie

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pab
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Randi,

Did you call & get the specifics?

--------------------
Peggy

~ ~ Hope is a powerful medicine. ~ ~

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MY3BOYS
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ok...update for 3/12

i did get the same letter, mother in law gave it
to me today. she said came in mail yest. but i
was napping and then she forgot about it.

so, i did call his office yesterday to question rumor of no ins. and said is tenitive and at least 60-90 days out, this was 3/11/09


Today--3/12/09
read the letter , sounds like exact same
you got randi. no dates, no specifics.

called today, said i got this letter in the mail
about no ins. etc, does not say when effective
and we have appt next week,

his sec. did state this will be effective in june sometime. Our appt this month ARE covered under ins.

we plan to talk to him more about this next wk

i am gonna pray since i do test cdc + (this is just my case) that dr will take ins then???? hoping

will post update on this thread after appt?? would that help???

also, at my last appt.(feb 09) he was telling me he had
already stopped ob all together, and gyn on 1
day week, and phasing out that

did say is switching to full time lyme as his
office is filling up fast for lyme, and taking
men is needed as well. this was last mo.

betty g,:: if this info should not go here pls remove or ask me to but this is the details:

to clarrify letter itself: says that after much thought is tx lyme pt on full time basis. tries to be nice about the phrasing but

initial appt $395.00;
f/u $195.00 for 30 min in office fu;
$150.00 30 min phone consult
need to have in house visit at least 1x every 3 mo.
phone consults may be arranged once stable

i can say, yes i am upest, so far our ins. has not had any prob paying/ auth for my tx - but i am CDC +

i want to ask him about the details, letter says is cancelling all ins. contracts - not sure for our plan if will pay out of network if not on contract at all, did not for my rhum. i used to see for yrs- had to pay 100% ($150) and ins would
NOT reimburse, but we have private policy, so all ins are different


hope this clarrifies, and randi- you were deff. not the only one who got the letter, is same
standard letter going to all, is confusing since there is no "effective" date

--------------------
i am not a Dr. any info is only for education, suggestion or to think/research. please do not mis-intuprest as diagnostic or prescriptive, only trying to help. **

dx in 08:lyme, rmsf, bart, babs, and m.pneumonia.

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bettyg
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MY3BOYS,

thank you so much for the update and clarifying.

NO insurance will be effective in JUNE 09, NO SPECIFIC DATE YET!
*******************************************

this is what majority of us have been going thru for quite awhile.

best wishes; at least you now have a full-time llmd vs. here and there! that's one thing you gained with him dropping his former occupation.

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METALLlC BLUE
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I need information on "In house visit." He doesn't make house-calls right? You mean "in the office, yes?"

--------------------
I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.

E-mail: [email protected]

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MY3BOYS
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yes, in his office. no house calls. only option of phone consults AFTER you are establish and on "stable" tx was what he explained to me at my last appt.;

this was in reference to my case as current tx going for 4 mo as long as i can tolerate it--so far so good-- i guess anyway.

this tx has finally trashed me out feeling like *&#@ so, thats the herx he was looking for i think.

doxy, cipro, ceftin didnt hit me this hard!!

--------------------
i am not a Dr. any info is only for education, suggestion or to think/research. please do not mis-intuprest as diagnostic or prescriptive, only trying to help. **

dx in 08:lyme, rmsf, bart, babs, and m.pneumonia.

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MY3BOYS
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oh what a wonderful world that would be..imagine..LLMD...house calls...and takes any/all insurance!!!

there are medicare / geriatric groups here who do just that- but would be to great to get LLMD to be that way

--------------------
i am not a Dr. any info is only for education, suggestion or to think/research. please do not mis-intuprest as diagnostic or prescriptive, only trying to help. **

dx in 08:lyme, rmsf, bart, babs, and m.pneumonia.

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METALLlC BLUE
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If anyone has further reports on Lyme friendly physicians or on this Dr. let me know. So far I've collected quite a bit more data on this LLMD. People really like the care received.

As time passes the more reports I collect in TX the better things are. I've surprisingly found quite a few "off the radar" folks who treat Lyme Disease because they themselves had Lyme Disease, or their family members. The tide is turning in TX, but it's a very huge state, so it's still a fraction compared to what would be optimal.

--------------------
I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.

E-mail: [email protected]

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sparkle7
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It's rough... I haven't had health insurance since 2001.

I was finally diagnosed with Lyme by the Fibromyalgia & Fatigue Center in Ct about 3 years ago. I had to pay out of pocket & it was over $10,000 for all the tests, IVs, supplements, drugs, etc. It didn't really help me but I was glad I had a diagnosis. Even that was a "clinical" one...

After almost 13 years of illness - it's wiped us out. That's why I'm so big on low cost alternative treatments. It's not for everyone but the mainstream ideas about how to cure this just didn't work for me.

I have many doubts about how accurate the tests are. The drugs didn't help me & they cost a fortune. I was denied disability even though I can't work - not that don't want to... Every day I wake up & have no idea how I'll be feeling. How is one supposed to live like this?

"It's not easy being (Lyme) green" - I think Kermit the frog said that... Just trying for a laugh... You have to have some kind of sense of humor in all of this disaster.

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LaurenTurner
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RandiBear, I got the letter too. I was really shocked and disappointed when I read it. I did call and was told that they would take insurance until June. So at least my next appointment at the end of March will be covered.

I hope you can figure out a way to cover the cost. I really hate that he is dropping insurance. It's going to make it hard for so many people. I understand where he's coming from, but it does really suck.

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