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DaVinci & insurance coverage... or lack of, rather! DaVinci & insurance coverage... or lack of, rather!

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  #1  
Unread 12-13-2011, 01:10 PM
DaVinci & insurance coverage... or lack of, rather!

Hello, all my fellow DaVinci Hyster-Sisters!

I've looked for this topic and haven't found mention of it. My insurance company refuses to pay for the DaVinci portion of my surgery because they claim that it is still 'experimental' surgery. My doctor has dealt with this for 3 years now & done hundreds of surgeries with it... to no avail. And I have had to pay $2,000 out of pocket for the DaVinci robot portion. When you research, many hospitals & doctors are offering it. How long before its not considered experimental?!

I hope I'm not crossing boundaries by asking if any of you have experienced similar with your insurance companies. I want to appeal, but not sure of process. Doc office has given up and refuses to assist in an appeal.
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  #2  
Unread 12-13-2011, 01:19 PM
Re: DaVinci & insurance coverage... or lack of, rather!

Wow!! The procedure has been around for 5 years. I have <oops! no insurance company names, please> and haven't been billed yet. I'll be curious to see what they have to say...
  #3  
Unread 12-13-2011, 01:25 PM
Re: DaVinci & insurance coverage... or lack of, rather!

Please keep us posted, kbid!
Interestingly, I just found out that my long-time pet sitter's son trains the doctors how to operate the DaVinci... and she confirmed what I was experiencing.

One thing my doctors office did tell me was that <oops! no insurance company names, please> told another patient that they did not care how the doctor removed the uterus, they weren't paying a single penny more for the procedure. -?????-
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  #4  
Unread 12-13-2011, 01:50 PM
Re: DaVinci & insurance coverage... or lack of, rather!

Yikes.... I did get a statement yesterday just itemized with EVERYTHING -- doctors, medication, OR, overnight, etc and it was about $38,000. Insurance better take up a boatload of that!!
  #5  
Unread 12-13-2011, 02:02 PM
Re: DaVinci & insurance coverage... or lack of, rather!

I got my statement today- $24,000!!! After insurance I still owe $1000. Hope I win the lottery!
  #6  
Unread 12-13-2011, 02:30 PM
Re: DaVinci & insurance coverage... or lack of, rather!

Oops! So sorry to have mentioned my insurance company, moderator!

If any of you experience refusal of claim for the DaVinci portion, I'd love to hear what your experience is. I feel that I should appeal it. Even if I don't get it reversed for me, i feel I need to speak up to help those after me.

Haven't gotten any bills, yet. I do know my doctors portion was $4690, though. But, maybe that's crazy CA!
  #7  
Unread 12-13-2011, 04:29 PM
Re: DaVinci & insurance coverage... or lack of, rather!

Is this higher DaVinci billing on the hospital bill or the surgeon's bill? Or both?

I have not seen my hospital bill yet but my surgeon's bill was a little high. They ALWAYS bill for more than they will get. That's true in or out of network...for ANY kind of bill.

I'm wondering how much the DaVinci adds to the hospital or surgeon's bill.
  #8  
Unread 12-13-2011, 06:36 PM
Re: DaVinci & insurance coverage... or lack of, rather!

Wow, I have no advice. Just wanted to say I'm sorry! That is a HUGE bummer!!! Can you appeal it at all?
  #9  
Unread 12-13-2011, 07:11 PM
Re: DaVinci & insurance coverage... or lack of, rather!

I don't know if the hospital bills additional for the DaVinci, but of my doctor's fee of $4690, his administrator said $2000 of that amount is for the DaVinci. I had to pre-pay his fee in full (ouch!) before surgery so he wouldn't be out of whatever the insurance refuses to cover. And, though he is a Network Physician, he must bill considerably higher but didn't like losing that income. Guess he's no dummy!

I am very happy with his work, though. And, I will try to appeal :-/
  #10  
Unread 12-13-2011, 08:34 PM
Re: DaVinci & insurance coverage... or lack of, rather!



Here is something that might help, taken from our page describing the da Vinci Hysterectomy:

  Quote:
Are you having difficulty with insurance covered of robotic-assisted surgery? Call the Reimbursement Hotline: 1-888-868-4647 x3128.
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