Re: Insurance procedure for Belgium

[Guest guest]

Hey Mark, I was wondering the same thing...looks like I'll be headed

to Belgium as well...don't know exactly when but I'm into the details

now. Who is your insurance carrier? I asked DeSmet this question in

an e-mail...I'll give you his verbatum reply later when I have a

chance to look it up.... Susie in Memphis

> Hi all,

>

> I am working the details for my operation with Dr De Smet and I

wonder if I should inform my insurance company of my plans before

going to Belgium? Or should I wait until I get back and then file for

a claim with required information?

> Thanks.

> Mark.

>

>

>

> __________________________________________________

>

[Guest guest]

Hi Susie,

Mine is Blue Cross Blue Shield. I am scheduled with Dr De Smet for the last week

of September. I am also into the details for lodging, transportation, etc. I was

in Belgium two weeks ago and was able to gather some information for my next

trip in September. Let's keep in touch.

Mark.

susettejk susettejk@...> wrote:

Hey Mark, I was wondering the same thing...looks like I'll be headed

to Belgium as well...don't know exactly when but I'm into the details

now. Who is your insurance carrier? I asked DeSmet this question in

an e-mail...I'll give you his verbatum reply later when I have a

chance to look it up.... Susie in Memphis

> Hi all,

>

> I am working the details for my operation with Dr De Smet and I

wonder if I should inform my insurance company of my plans before

going to Belgium? Or should I wait until I get back and then file for

a claim with required information?

> Thanks.

> Mark.

>

>

>

> __________________________________________________

>

[Guest guest]

Hey Mark! DeSmet said " Some patients got a reimbursement by

insurance. You can ask with your insurance or let us know what

insurance it is? " That was it. Fairly non-specific. I have

Unitedhealthcare. If I were you I would just e-mail his office the

insurance info and see what they say. I think the earliest I will be

able to go will be November. I'm still trying to assess that fine

line between hurting enough to have it done and " oops you've waited

too long " . I asked DeSmet about waiting and he told me it was hard

to predict the future. I truly don't know what to do but we're

supposed to go to the olympics in late Aug/early Sept and I think

all of that hobbling around will tell the tale. Susie in Memphis

> Hey Mark, I was wondering the same thing...looks like I'll be

headed

> to Belgium as well...don't know exactly when but I'm into the

details

> now. Who is your insurance carrier? I asked DeSmet this question

in

> an e-mail...I'll give you his verbatum reply later when I have a

> chance to look it up.... Susie in Memphis

>

>

>

>

> > Hi all,

> >

> > I am working the details for my operation with Dr De Smet and I

> wonder if I should inform my insurance company of my plans before

> going to Belgium? Or should I wait until I get back and then file

for

> a claim with required information?

> > Thanks.

> > Mark.

> >

> >

> >

> > __________________________________________________

> >

[Guest guest]

Hey Susie,

Thanks for sharing this information with me. I will ask Hugo, Dr De Smet's

assistant, how should I proceed with my insurance. I wasn't really sure if I

should raise a flag with my health insurance company before leaving the U.S. to

Belgium. But as you said I will ask Dr Smet.

Regarding your decision about going through this whole thing, I can only say

that if you are not in desperate pain and your case is not as bad as it is for

many of us, then take your time and do your research to answer yourself all the

questions you have doubts about it. I think we are sharing similar situation

about making a decision. I asked Dr de Smet the same question about waiting and

he answered the same thing about the future. But he gave me good reasons why to

improve the quality of my life. And I think I undestand what he was trying to

do.

If you ever have a chance to go see him before you make your decision, do so. It

helped me to clarify my final doubts.

Mark.

susettejk susettejk@...> wrote:Hey Mark! DeSmet said " Some patients got

a reimbursement by

insurance. You can ask with your insurance or let us know what

insurance it is? " That was it. Fairly non-specific. I have

Unitedhealthcare. If I were you I would just e-mail his office the

insurance info and see what they say. I think the earliest I will be

able to go will be November. I'm still trying to assess that fine

line between hurting enough to have it done and " oops you've waited

too long " . I asked DeSmet about waiting and he told me it was hard

to predict the future. I truly don't know what to do but we're

supposed to go to the olympics in late Aug/early Sept and I think

all of that hobbling around will tell the tale. Susie in Memphis

> Hey Mark, I was wondering the same thing...looks like I'll be

headed

> to Belgium as well...don't know exactly when but I'm into the

details

> now. Who is your insurance carrier? I asked DeSmet this question

in

> an e-mail...I'll give you his verbatum reply later when I have a

> chance to look it up.... Susie in Memphis

>

>

>

>

> > Hi all,

> >

> > I am working the details for my operation with Dr De Smet and I

> wonder if I should inform my insurance company of my plans before

> going to Belgium? Or should I wait until I get back and then file

for

> a claim with required information?

> > Thanks.

> > Mark.

> >

> >

> >

> > __________________________________________________

> >

[Guest guest]

Hey Susie,

Thanks for sharing this information with me. I will ask Hugo, Dr De Smet's

assistant, how should I proceed with my insurance. I wasn't really sure if I

should raise a flag with my health insurance company before leaving the U.S. to

Belgium. But as you said I will ask Dr Smet.

Regarding your decision about going through this whole thing, I can only say

that if you are not in desperate pain and your case is not as bad as it is for

many of us, then take your time and do your research to answer yourself all the

questions you have doubts about it. I think we are sharing similar situation

about making a decision. I asked Dr de Smet the same question about waiting and

he answered the same thing about the future. But he gave me good reasons why to

improve the quality of my life. And I think I undestand what he was trying to

do.

If you ever have a chance to go see him before you make your decision, do so. It

helped me to clarify my final doubts.

Mark.

susettejk susettejk@...> wrote:Hey Mark! DeSmet said " Some patients got

a reimbursement by

insurance. You can ask with your insurance or let us know what

insurance it is? " That was it. Fairly non-specific. I have

Unitedhealthcare. If I were you I would just e-mail his office the

insurance info and see what they say. I think the earliest I will be

able to go will be November. I'm still trying to assess that fine

line between hurting enough to have it done and " oops you've waited

too long " . I asked DeSmet about waiting and he told me it was hard

to predict the future. I truly don't know what to do but we're

supposed to go to the olympics in late Aug/early Sept and I think

all of that hobbling around will tell the tale. Susie in Memphis

> Hey Mark, I was wondering the same thing...looks like I'll be

headed

> to Belgium as well...don't know exactly when but I'm into the

details

> now. Who is your insurance carrier? I asked DeSmet this question

in

> an e-mail...I'll give you his verbatum reply later when I have a

> chance to look it up.... Susie in Memphis

>

>

>

>

> > Hi all,

> >

> > I am working the details for my operation with Dr De Smet and I

> wonder if I should inform my insurance company of my plans before

> going to Belgium? Or should I wait until I get back and then file

for

> a claim with required information?

> > Thanks.

> > Mark.

> >

> >

> >

> > __________________________________________________

> >

[Guest guest]

Hi Mark,

This was my experience: I have the Blue Shield of California PPO plan and they

covered about 2/3 (hospital portion) of my bill when I had my left hip

resurfaced in

Belgium in '02.

I am planning to go back to have my other hip resurfaced on September 7th and

just

called the BS International division to open my case (which I did the first time

around

too).

I remember in '02, the BS agent didn't know much about resurfacing but was very

interested in what I had to say about it. I told her they should be sending

everyone to

Europe because at that time, it was so much cheaper...$9,500 as opposed to

$35,000

in LA. She was very nice and told me to just send them the translated bills

when I

received them (it took about 6 months to get them from De Smet). Then, I think

I

received a check from Blue shield within a month of sending in the bills.

BTW, I do know of one other woman with BS of Calif. who was successful in

getting

re-imbursed. Let me know if you have any other questions.

Best, Donna LBHR 11/13/02 De Smet

> Hi all,

>

> I am working the details for my operation with Dr De Smet and I wonder if I

should

inform my insurance company of my plans before going to Belgium? Or should I

wait

until I get back and then file for a claim with required information?

> Thanks.

> Mark.

>

>

>

> __________________________________________________

>

[Guest guest]

Hi Susie,

I played the waiting game and got lucky--I had a bone-on-bone x-ray

result in 2001, skated another year and was successfully resurfaced in

2002. Actually, I wasn't " playing " the game, I had been told by my

local OS that THR was the only answer and that would be the end of

skating. I learned about resurfacing over on Totally Hip--thank you for

saving me Cap'n Amaze-O.

I'm posting because it was my personal experience that when it got

REALLY bad as far as pain levels that it happened very quickly and got

more severe very quickly. Toward the end, I was waking up in pain every

2 hours.

I hope you are able to have a great time at the Olympics.

Skater Gwen

C2K 9/16/02 Dr. Gross

susettejk wrote:

>Hey Mark! DeSmet said " Some patients got a reimbursement by

>insurance. You can ask with your insurance or let us know what

>insurance it is? " That was it. Fairly non-specific. I have

>Unitedhealthcare. If I were you I would just e-mail his office the

>insurance info and see what they say. I think the earliest I will be

>able to go will be November. I'm still trying to assess that fine

>line between hurting enough to have it done and " oops you've waited

>too long " . I asked DeSmet about waiting and he told me it was hard

>to predict the future. I truly don't know what to do but we're

>supposed to go to the olympics in late Aug/early Sept and I think

>all of that hobbling around will tell the tale. Susie in Memphis

>

>

>>Hey Mark, I was wondering the same thing...looks like I'll be

>>

>>

>headed

>

>

>>to Belgium as well...don't know exactly when but I'm into the

>>

>>

>details

>

>

>>now. Who is your insurance carrier? I asked DeSmet this question

>>

>>

>in

>

>

>>an e-mail...I'll give you his verbatum reply later when I have a

>>chance to look it up.... Susie in Memphis

>>

>>

>>

>>

>>

>>

>>>Hi all,

>>>

>>>I am working the details for my operation with Dr De Smet and I

>>>

>>>

>>wonder if I should inform my insurance company of my plans before

>>going to Belgium? Or should I wait until I get back and then file

>>

>>

>for

>

>

>>a claim with required information?

>>

>>

>>>Thanks.

>>>Mark.

>>>

>>>

>>>

>>>__________________________________________________

>>>

[Guest guest]

Hi Susie,

I played the waiting game and got lucky--I had a bone-on-bone x-ray

result in 2001, skated another year and was successfully resurfaced in

2002. Actually, I wasn't " playing " the game, I had been told by my

local OS that THR was the only answer and that would be the end of

skating. I learned about resurfacing over on Totally Hip--thank you for

saving me Cap'n Amaze-O.

I'm posting because it was my personal experience that when it got

REALLY bad as far as pain levels that it happened very quickly and got

more severe very quickly. Toward the end, I was waking up in pain every

2 hours.

I hope you are able to have a great time at the Olympics.

Skater Gwen

C2K 9/16/02 Dr. Gross

susettejk wrote:

>Hey Mark! DeSmet said " Some patients got a reimbursement by

>insurance. You can ask with your insurance or let us know what

>insurance it is? " That was it. Fairly non-specific. I have

>Unitedhealthcare. If I were you I would just e-mail his office the

>insurance info and see what they say. I think the earliest I will be

>able to go will be November. I'm still trying to assess that fine

>line between hurting enough to have it done and " oops you've waited

>too long " . I asked DeSmet about waiting and he told me it was hard

>to predict the future. I truly don't know what to do but we're

>supposed to go to the olympics in late Aug/early Sept and I think

>all of that hobbling around will tell the tale. Susie in Memphis

>

>

>>Hey Mark, I was wondering the same thing...looks like I'll be

>>

>>

>headed

>

>

>>to Belgium as well...don't know exactly when but I'm into the

>>

>>

>details

>

>

>>now. Who is your insurance carrier? I asked DeSmet this question

>>

>>

>in

>

>

>>an e-mail...I'll give you his verbatum reply later when I have a

>>chance to look it up.... Susie in Memphis

>>

>>

>>

>>

>>

>>

>>>Hi all,

>>>

>>>I am working the details for my operation with Dr De Smet and I

>>>

>>>

>>wonder if I should inform my insurance company of my plans before

>>going to Belgium? Or should I wait until I get back and then file

>>

>>

>for

>

>

>>a claim with required information?

>>

>>

>>>Thanks.

>>>Mark.

>>>

>>>

>>>

>>>__________________________________________________

>>>

[Guest guest]

Hi Mark,

I am the other woman in CA with BS. My case was this: I applied

initially for coverage at JRI with Dr. Schmalzreid, and they denied.

So I didn't want to wait, plus, they had a 45 day hold on the devices

that summer. I scheduled with Dr. DeSmet and went. When I came back,

BS had reversed their decision on the first appeal. I'm glad I went

anyway!

Then it took about 8 months for the papers to come from Belgium, and

I took even longer to send them... we have 1 year. At the end I

scrambled to get it together, sent a cover letter and the paperwork,

and fedexed it so I would have a receipt. I was sure it was going to

come back needing a translation, but one page was in English and I

guess that was sufficient. A few weeks later I received a check for

more than 80% and I was very pleased. Done deal.

Good luck, Mark, sometimes it depends on who is reading your case, so

it does pay to appeal.

Isara

> > Hi all,

> >

> > I am working the details for my operation with Dr De Smet and I

wonder if I should

> inform my insurance company of my plans before going to Belgium? Or

should I wait

> until I get back and then file for a claim with required

information?

> > Thanks.

> > Mark.

> >

> >

> >

> > __________________________________________________

> >

[Guest guest]

Hi Isara,

Thank you for telling me about your case. I think I am going to write to Hugo

and let him know about my insurance. I agree with you, it is a matter of whom is

reading the case. I think BCBS expects a claim to be file someday because they

have been paying my OS visits and ex-rays in the last 5 months. What they don't

know yet is if the claim it is going to be through an U.S. or foreign OS.

They'll find out.

Thanks again.

Mark

Isara isara11@...> wrote:

Hi Mark,

I am the other woman in CA with BS. My case was this: I applied

initially for coverage at JRI with Dr. Schmalzreid, and they denied.

So I didn't want to wait, plus, they had a 45 day hold on the devices

that summer. I scheduled with Dr. DeSmet and went. When I came back,

BS had reversed their decision on the first appeal. I'm glad I went

anyway!

Then it took about 8 months for the papers to come from Belgium, and

I took even longer to send them... we have 1 year. At the end I

scrambled to get it together, sent a cover letter and the paperwork,

and fedexed it so I would have a receipt. I was sure it was going to

come back needing a translation, but one page was in English and I

guess that was sufficient. A few weeks later I received a check for

more than 80% and I was very pleased. Done deal.

Good luck, Mark, sometimes it depends on who is reading your case, so

it does pay to appeal.

Isara

> > Hi all,

> >

> > I am working the details for my operation with Dr De Smet and I

wonder if I should

> inform my insurance company of my plans before going to Belgium? Or

should I wait

> until I get back and then file for a claim with required

information?

> > Thanks.

> > Mark.

> >

> >

> >

> > __________________________________________________

> >

[Guest guest]

Hi Isara,

Thank you for telling me about your case. I think I am going to write to Hugo

and let him know about my insurance. I agree with you, it is a matter of whom is

reading the case. I think BCBS expects a claim to be file someday because they

have been paying my OS visits and ex-rays in the last 5 months. What they don't

know yet is if the claim it is going to be through an U.S. or foreign OS.

They'll find out.

Thanks again.

Mark

Isara isara11@...> wrote:

Hi Mark,

I am the other woman in CA with BS. My case was this: I applied

initially for coverage at JRI with Dr. Schmalzreid, and they denied.

So I didn't want to wait, plus, they had a 45 day hold on the devices

that summer. I scheduled with Dr. DeSmet and went. When I came back,

BS had reversed their decision on the first appeal. I'm glad I went

anyway!

Then it took about 8 months for the papers to come from Belgium, and

I took even longer to send them... we have 1 year. At the end I

scrambled to get it together, sent a cover letter and the paperwork,

and fedexed it so I would have a receipt. I was sure it was going to

come back needing a translation, but one page was in English and I

guess that was sufficient. A few weeks later I received a check for

more than 80% and I was very pleased. Done deal.

Good luck, Mark, sometimes it depends on who is reading your case, so

it does pay to appeal.

Isara

> > Hi all,

> >

> > I am working the details for my operation with Dr De Smet and I

wonder if I should

> inform my insurance company of my plans before going to Belgium? Or

should I wait

> until I get back and then file for a claim with required

information?

> > Thanks.

> > Mark.

> >

> >

> >

> > __________________________________________________

> >

[Guest guest]

Hi Mark. You know, it would probably help to tell BS that you know

of two women who were covered for resurfacing in Belgium. I'm

pretty sure I used Isara's name when I opened my case the first time

and you can use mine too. Why don't you contact me directly. Best,

Donna 11/13/02 LBHR De Smet

-- In surfacehippy , Mark McDale

wrote:

> Thanks Donna,

>

> So it would be wise to open a case with BCBS before I go to

Belgium in September. I had the impression that a health insurance

company's reimbursement procedure is based on when a pre-condition

is reported. In our case, I think it would make a difference if

reported prior or after the fact. But I am not sure. Knowing that

there are so many rules to get approved, I am not trying to hide

anything, I am just trying to find the way we are going to benefit

the most. What do you think Donna?

> Mark.

>

> donnakei wrote:

>

> Hi Mark,

>

> This was my experience: I have the Blue Shield of California PPO

plan and they

> covered about 2/3 (hospital portion) of my bill when I had my left

hip resurfaced in

> Belgium in '02.

>

> I am planning to go back to have my other hip resurfaced on

September 7th and just

> called the BS International division to open my case (which I did

the first time around

> too).

>

> I remember in '02, the BS agent didn't know much about resurfacing

but was very

> interested in what I had to say about it. I told her they should

be sending everyone to

> Europe because at that time, it was so much cheaper...$9,500 as

opposed to $35,000

> in LA. She was very nice and told me to just send them the

translated bills when I

> received them (it took about 6 months to get them from De Smet).

Then, I think I

> received a check from Blue shield within a month of sending in the

bills.

>

> BTW, I do know of one other woman with BS of Calif. who was

successful in getting

> re-imbursed. Let me know if you have any other questions.

>

> Best, Donna LBHR 11/13/02 De Smet

>

>

>

>

>

>

>

>

> > Hi all,

> >

> > I am working the details for my operation with Dr De Smet and I

wonder if I should

> inform my insurance company of my plans before going to Belgium?

Or should I wait

> until I get back and then file for a claim with required

information?

> > Thanks.

> > Mark.

> >

> >

> >

> > __________________________________________________

> >

[Guest guest]

Hi Mark. You know, it would probably help to tell BS that you know

of two women who were covered for resurfacing in Belgium. I'm

pretty sure I used Isara's name when I opened my case the first time

and you can use mine too. Why don't you contact me directly. Best,

Donna 11/13/02 LBHR De Smet

-- In surfacehippy , Mark McDale

wrote:

> Thanks Donna,

>

> So it would be wise to open a case with BCBS before I go to

Belgium in September. I had the impression that a health insurance

company's reimbursement procedure is based on when a pre-condition

is reported. In our case, I think it would make a difference if

reported prior or after the fact. But I am not sure. Knowing that

there are so many rules to get approved, I am not trying to hide

anything, I am just trying to find the way we are going to benefit

the most. What do you think Donna?

> Mark.

>

> donnakei wrote:

>

> Hi Mark,

>

> This was my experience: I have the Blue Shield of California PPO

plan and they

> covered about 2/3 (hospital portion) of my bill when I had my left

hip resurfaced in

> Belgium in '02.

>

> I am planning to go back to have my other hip resurfaced on

September 7th and just

> called the BS International division to open my case (which I did

the first time around

> too).

>

> I remember in '02, the BS agent didn't know much about resurfacing

but was very

> interested in what I had to say about it. I told her they should

be sending everyone to

> Europe because at that time, it was so much cheaper...$9,500 as

opposed to $35,000

> in LA. She was very nice and told me to just send them the

translated bills when I

> received them (it took about 6 months to get them from De Smet).

Then, I think I

> received a check from Blue shield within a month of sending in the

bills.

>

> BTW, I do know of one other woman with BS of Calif. who was

successful in getting

> re-imbursed. Let me know if you have any other questions.

>

> Best, Donna LBHR 11/13/02 De Smet

>

>

>

>

>

>

>

>

> > Hi all,

> >

> > I am working the details for my operation with Dr De Smet and I

wonder if I should

> inform my insurance company of my plans before going to Belgium?

Or should I wait

> until I get back and then file for a claim with required

information?

> > Thanks.

> > Mark.

> >

> >

> >

> > __________________________________________________

> >