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Posted 9/17/2011 5:10 AM (GMT 0)
Hi everyone, We are new here and trying to decide between doctors. Dr. Alhering at UC Irvine is impressive because of his special added thermal cooling technique during surgery but he doesn't take our insurance. Trying to decide between him and Wilson/Kawachi at City of Hope who we haven't met with yet but heard great things about and they take our insurance. This whole process is so difficult. First it was what proceddure and now what doctor. PLEASE help us with any advice SOON. We have a tentative surgery with Ahlering and have to decide this coming week.
PSA less than 4 and Gleason is 7. stage T1, one core postitive

Post Edited (lucy forever) : 9/17/2011 9:24:18 AM (GMT-6)

Posted 9/17/2011 4:23 PM (GMT 0)
All the doctors you mentoned are excellent surgeons with excellent reputations. I think the difference will be minimal between them. Not taking insurance doen't mean that insurance won't pay; it just means that you will have to submit the claim instead of the doctor and the insurance will reimburse you. You will have to come up with cash to pay the doctor.
JT
Posted 9/17/2011 5:09 PM (GMT 0)
Thanks for your input. Well, Dr. Ahlering is out of our network and insurance will reimburse minimally. Do you know these doctors and again how should I decide between them.
Posted 9/17/2011 5:34 PM (GMT 0)
Make sure you know exactly what your insurance will and will not pay. Then find out exactly how much your doctor will charge. My doctor was out of network, but the insurance paid EVERYTHING but his fee. The hospital bill was in the $70,000 range and they paid that. I talked to the doctor's office manager (beforehand) and found out his fee would be approx. $2500. I could afford $2500, and I thought it was worth it to get the doctor I wanted. I sure could not have afforded $70,000!
Posted 9/17/2011 5:40 PM (GMT 0)
Lucy

I was in the same spot you are today only 2 years ago. I went with Kawachi because of insurance. He his a excellent surgeon who has performed over 3,000 robotic rp. The problem i had with him was his bed side manner. He is very arrogant and when asked questions he seem burdened to have to answer them. I had a small problem a week after surgery. I think I had some kind of blockage in the uretha tube which caused me pain. I went to see him regarding this and said he could see nothing wrong without even exaimineing me. He saidit only takes time.This went on for 2 months. I finally demanded he do a cysoctomy. When he was done he said there was no problem but lo and behold the pain was gone which leads me to believe that the camera removed the blockage. Again it is the COH and I was afforded a clinical trial which I went on due to my agressive cancer. It is a very good hodpital but remember it is more of a research facility than a patients hospital. Best of luck.

FIGHT ON.

Posted 9/17/2011 6:09 PM (GMT 0)
The insurance and medicare, I don't believe will pay. When you go to Dr Ahlering (great doctor) you sign a contract stating that you will not file a claim for medical reimbursement. I don't exactly recall if it applies only to medicare and secondary insurance or to all insurance. I am also considering him due to his skills and the Hypothermic enhanced DaVinci.  By the way, I was informed that the hospital and all other surgery expenses would be covered by the Medicare/insurance.
Posted 9/17/2011 10:32 PM (GMT 0)
I heard that Alhering deals with it this way. We are charged up front the 6,000 plus and then since his is out of network, we pay our deductible and anything over the contracted rate (which is 1,000 plus). Insurance only picks up the 60% of the contracted rate. SO, I am hearing good stuff about Aherling but wonder if Kawachi/Wilson are just as good. The bedside manner of Kawachi I just read about in here doesn't sound very good and I do appreciate a kind doctor which I think Ahlering is. thanks for your input.
Posted 9/17/2011 10:36 PM (GMT 0)
Just trying to decide if Ahlering is worth the 5,000 more than the City of Hope doctors, Wilson/Kawachi. We also can get in sooner to Ahlering and though we haven't been given a time limit (find a therapy in about 3 months) it's driving us crazy trying to figure this stuff out and want to get it over with. What would you do????
Posted 9/17/2011 10:37 PM (GMT 0)
I was very impressed with Dr. Ahlering during the consultation and with his cooling technique. During the consultation he was very thorough and had the numbers and experience to back up everything he was telling me. I will make my decision after the appointment I have at CoH in a couple of weeks.
Posted 9/17/2011 11:03 PM (GMT 0)
Lucy,

You ask "what would you do?" Phrased that way, it was easy. My private insurance situation did not permit me to absorb extra costs (not old enough for Medicare, no VA, just ultra-high deductible coverage as an employee). I had to stay in network, period.

As to choosing a doctor, if economics allow, choose the one with what you deem to be adequate experience, and with which you are comfortable. I had to research within my network plan, and have had no issues.

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