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Novice
Picture of OnnaBugeisha
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I think I am going to take a day off of work (where I don't have to go to my second job after) and call my insurance to see how this will work and and call Jefferson to see if I can get the coding of the people there to see how they will bill the consults to see if it will be covered. My husband and I talked it over the other day and he made it clear in HIS opinion that I should cancel the appointment if insurance will not cover the majority of it since we cannot afford it.

He is a private contractor and we haven't been able to save a dime towards taxes (We did, but I have a crappy car and every few months I have to dump several hundred into fixing it) and April is tax month... so that will be a REALLY bad month for us to dish out that amount in full. If Jefferson had a payment plan, it might be easier, but the lady made it clear on the phone that it had to be paid in full at the time of the appointment.

Also, say they do think I need psychological help of some form and think I need therapy, I will not be able to afford this persons rate if this is what they charge all the time. This is a bit out of my range when I can see someone in my preferred plan and pay pennies on the dollar.

I guess I need to take a step back, calm down, and just start off with making the phone calls and seeing if it will even be covered after the fact... and if it is, I need to find a way to come up with the money by April and I am still not sure how I can do that. Head Banging Why can't they just do payment plans??


~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~

Defeat may test you; it need not stop you. If at first you don't succeed, try another way. For every obstacle there is a solution. Nothing in the world can take the place of persistence. The greatest mistake is giving up.
 
Posts: 99 | Location: Delaware | Registered: 12-12-2011Report This Post
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Supreme Guru
Picture of Teri Robert
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I'm sorry this is so difficult for you. Been there. I also understand the private contractor situation. My work is all contracted, so come April, if I haven't been paying quarterly estimated taxes, we have all the taxes to pay too.

To address your question about what if they think you need to see them again -- remember that any follow-up appointments would cost FAR less than the first one. The first one is so high because any first appointment is higher, and it includes the testing.

Your plan of calming down and making those phone calls is very sound. I'll try to keep an eye on this thread and offer any comments and support I can. If I miss something, please know that you can email me at the email address in my signature.

quote:
Originally posted by OnnaBugeisha:
I think I am going to take a day off of work (where I don't have to go to my second job after) and call my insurance to see how this will work and and call Jefferson to see if I can get the coding of the people there to see how they will bill the consults to see if it will be covered. My husband and I talked it over the other day and he made it clear in HIS opinion that I should cancel the appointment if insurance will not cover the majority of it since we cannot afford it.

He is a private contractor and we haven't been able to save a dime towards taxes (We did, but I have a crappy car and every few months I have to dump several hundred into fixing it) and April is tax month... so that will be a REALLY bad month for us to dish out that amount in full. If Jefferson had a payment plan, it might be easier, but the lady made it clear on the phone that it had to be paid in full at the time of the appointment.

Also, say they do think I need psychological help of some form and think I need therapy, I will not be able to afford this persons rate if this is what they charge all the time. This is a bit out of my range when I can see someone in my preferred plan and pay pennies on the dollar.

I guess I need to take a step back, calm down, and just start off with making the phone calls and seeing if it will even be covered after the fact... and if it is, I need to find a way to come up with the money by April and I am still not sure how I can do that. Head Banging Why can't they just do payment plans??



Teri Robert
Lead Health Guide, HealthCentral Migraine Community
terimmc@helpforheadaches.com

Author of Living Well with Migraine Disease and Headaches

Stay up-to-date on Migraine info with my free weekly newsleter. Subscribe here

visit me on or

 
Posts: 4220 | Location: West Virginia | Registered: 01-11-2007Report This Post
Apprentice
Picture of Melanie Jane
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Onna,

I would at least ask them if they would consider making an exception in your case and allow you to do a payment plan for the initial fee.

Good luck!
 
Posts: 227 | Location: LA County, California | Registered: 02-25-2009Report This Post
MMC Lead Expert
Supreme Guru
Picture of Teri Robert
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Sadly, I can tell you that the answer to that will be no. It's university policy.

quote:
Originally posted by Melanie Jane:
Onna,

I would at least ask them if they would consider making an exception in your case and allow you to do a payment plan for the initial fee.

Good luck!



Teri Robert
Lead Health Guide, HealthCentral Migraine Community
terimmc@helpforheadaches.com

Author of Living Well with Migraine Disease and Headaches

Stay up-to-date on Migraine info with my free weekly newsleter. Subscribe here

visit me on or

 
Posts: 4220 | Location: West Virginia | Registered: 01-11-2007Report This Post
Master
Picture of JennyHOST
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Yep, Teri's definitely right. I tried to negotiate a monthly payment arrangement. Not allowed, unfortunately!

The bulk of the cost is the testing fees. I certainly don't think you'd be under any obligation to see their psychiatrist on an ongoing basis, even if they felt you could use such support. I know some folks who use Jefferson for HA/migraine care and consult with the psychiatrist only occasionally, choosing, instead, to see their local mental health provider regularly.

It's a hard decision, I know! In my case, I'd pay the $$ all over again. I'm receiving the best care ever at this facility...


JennyC
Forum Moderator
 
Posts: 354 | Location: PA | Registered: 04-02-2011Report This Post
Grasshopper
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While Jefferson won't take payments, the IRS will. http://www.irs.gov/Individuals...stallment-Agreements lays out payment plans for those that cannot pay their IRS taxes in full and all at once. There are draw backs, such as penalties and interest, but it is an alternative.

Good luck.
 
Posts: 28 | Registered: 07-27-2009Report This Post
Grasshopper
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Since this thread is already about the Jefferson Clinic, I figured I would add my question as well.

I am scheduled for July 9th (SO FAR AWAY!!) for my consultation appointment. How soon after your first appointment do they begin working on treatment with you?

[I am from Wisconsin, so it is going to be quite pricey for the first visit. If they are able to break my NDPH of 4+ years, it will be totally worth it though!]

I am going out to Jefferson to pursue inpatient lidocaine infusion. I received an hour of it, which brought my headache from an 8 to a 5-the lowest it has been in over a year. There are a lot of hoops for doctors to jump through to get a hospital to allow them to provide this service, as you have to be on a cardiac monitor and have constant supervision by someone who understands the possible complications. Have any of you experienced inpatient lidocaine infusion anywhere in the United States?
 
Posts: 42 | Location: Central WI | Registered: 11-17-2010Report This Post
Novice
Picture of OnnaBugeisha
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quote:
Originally posted by Tonya Marie:
Have any of you experienced inpatient lidocaine infusion anywhere in the United States?


A friend of my husband did it several times at Jefferson. It worked for her for a short amount of time. She did an inpatient stay for about a week I think. She said she was fairly out of it, but was happy to have her severe chronic migraine pain level decrease for a change. It wasn't enough for her to do something like that on a regular basis because it just lowered her pain cycle instead of breaking it entirely; however, she said she might consider it again if she were really having a rough go at it.

She no longer is a frequent patient of theirs, but she does go in as an emergency patient when needed. Hope that helps!


~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~

Defeat may test you; it need not stop you. If at first you don't succeed, try another way. For every obstacle there is a solution. Nothing in the world can take the place of persistence. The greatest mistake is giving up.
 
Posts: 99 | Location: Delaware | Registered: 12-12-2011Report This Post
Novice
Picture of OnnaBugeisha
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Hi everyone! My appointment is FINALLY just over two weeks away! Thumbs Up Is there anything you can think of that I should be doing or should have ready to take with me? I already have the crappy notes from my current neuro, along with the CD from my one and only MRI and CT I had done. I have yet to begin filling out the ton of paperwork from Jefferson, which I need to start doing soon! Did all of you print and take in your headache journal that you keep? When I did that for my current neuro, he didn't even want to see it and basically said it was a waste of his time to have it. I don't want to waste more of my time transferring the info into a spreadsheet and printiting it all if they won't want it.

Also, from reading my reports from my current neuro, I have a couple more questions I want to ask. My reports from my MRI and CT mention that I have a pineal cyst in my brain. There isn't too much info out there about them, but most of the info seems to say that they are relatively harmless, but they CAN cause headaches. My current neuro never even mentioned this to me. I guess he didn't think it was worth it?? I am hoping I can get some clarification about this while up there. I took a look at my disc and I spotted what I thought was the cyst myself. It looks like it isn't in the best of areas (as far as operations go, but it isn't like it is in the center of my brain, more like the underside), so I am guessing they tend to leave these alone unless absolutely required.

I am getting both excited AND nervous... and my husband is still a little annoyed that he has to take a day off of work without pay. Embarrassed I snapped at him and told him I'd find someone else to go with me since he is so inconvenienced and then he said he was sure I had plenty of other guys who'd be willing to take me. I have NO idea what that meant... Luckily, the snarky comments didn't escalate any further.

Anywho, thanks so much for your support everyone. Oh, on another note... I had one more blow to my ego! I had to donate blood for our blood bank membership and I went there and they weighed me and told me I didn't weigh enough! Evidently, I have lost too much weight thanks to good ol' topamax. Devil Not only do I have to hear on a daily basis "You are too thin." from everyone I know, none of my clothes fit anymore, but now I can't even donate blood!!! HMPH!


~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~

Defeat may test you; it need not stop you. If at first you don't succeed, try another way. For every obstacle there is a solution. Nothing in the world can take the place of persistence. The greatest mistake is giving up.
 
Posts: 99 | Location: Delaware | Registered: 12-12-2011Report This Post
Master
Picture of JennyHOST
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Hi Onna!

I'm so glad your appointment is coming soon! The folks at Jefferson have been terrific for me. I sure hope you'll have the same experience.

I think it'd be a good idea to take your headache/migraine diary. Dr. Silberstein may just glance at it, but it'll certainly help him to better analyze your migraine patterns. I know it may take a bit of work to get the diary together, but better safe than sorry!

I think it's very important for you to write down ALL of your questions and concerns. the appointment will move quickly, and you may forget things if you don't write them down.

Also, you need to make a list of all the medications, dosages, and any side effects you may have had. I take that list with me for every follow-up, too. It's easy to forget what you've tried--especially if it's been a while!

You may also want to peek at this article for other ideas: Migraineur's Guide To a Successful Doctor's Appointment.

I'm sorry, but I'm not familiar enough to speak about the pineal cyst. I think the only one who would have the training/experience to be able to address that is your doctor. I wish I had info to give to you, though!!

It stinks that your husband has a bad attitude about the appointment. Please don't let him bring you down! You certainly deserve the best care possible, and Jefferson is a great place to get that. My husband had been crabby about my need to travel to Philly on a couple of occasions. (For us, it involves a plane and train, so it's the travel $$ that stresses him out.) After seeing that the doctors at Jefferson were actually willing to try new treatments and give me the medical support I need, though, he's been much more patient. And I often do the trip alone, as I know my way around just fine at this point!

Oh, that topamax! It does bring about weight loss for lots of folks. Ask Dr. Silberstein about it--he may have some ideas.

Let us know if you have other questions! And be sure to update after your appointment!


JennyC
Forum Moderator
 
Posts: 354 | Location: PA | Registered: 04-02-2011Report This Post
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Supreme Guru
Picture of dragondroolHOST
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Definitely jot yourself a cheat sheet of questions. I don't know how often I would ask questions in my head for a week before an appointment, and then leave the appointment forgetting to ask some important question even though I'd "rehearsed" it ad nauseam. I'd usually remember it in the parking lot. Eventually I started jotting them down and digging out my list, just to make sure I hit everything.

Sorry about the blood donation issue. That's something I believe in, and I donate whenever I'm able, as long as my labs are okay. Lately it's been hitting me a little harder, and I'm not sure I'll be able to keep donating, but while I still can, I do. It makes me happy to know that my donation can buy someone priceless time with their loved one, even if it's just one extra day. I'm all about time with loved ones. Smiler I've found about seven to ten extra pounds in the last year-and-a-half. If it would help, I would share them with you, so that you might pass requirements. Big Grin



Dragondrool
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Posts: 6478 | Location: Montana | Registered: 01-11-2007Report This Post
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FINALLY had my first appointment! Thumbs Up It was an overwhelmingly long day that ended with an underwhelming appointment, but I am hopeful. My appointment was at 7 a.m. and they told me to be there 15 minutes early, so we left home at 5:30 a.m. When we got there and found the office, it was locked; evidently, they don't even arrive until 7 at the earliest. Someone finally strolled in at 7 to unlock the door and let us in, but they didn't really check me in for another fifteen minutes or so. Then the paperwork began. I filled out a bunch of paperwork and turned that in and then I got the 300 plus question psych eval test to take. I spoke with one of the psychologists. I don't recall her name, but she was really nice and easy to talk to. My husband went in the session with me and spoke about how he feels and towards the end, she asked him to leave so we could speak one on one for a bit. Once that was over, she told me what she thought and what her recommendation would be. She said that I have amazing coping skills from all of the thins I have experienced growing up and that it seems to be helping me cope well with the migraines. She said that I seem to have isolated incidents that may cause anxiety or depression and flare up my migraines, but she said these are normal behaviors and are noting to worry about and that she doesn't think I need regular therapy; however, she doesn't think it would hurt if I felt I needed a place to go every now and then just to unload since I have a lot of stress in my life right now due to work.

Once that was over, it was another 30-40 minute in the waiting room until we saw the nurse. We were in with her for about 15 minutes or so. She took a baseline of sorts as far as my meds, headaches, weight, BP, etc. Then she took me out in the hallway and took my photo. I was looking awful! I had a headache, was wearing a hoodie and had taken a nap while in the waiting room in hopes that it would take the headache away, so I am sure the photo is atrocious. Thumbs Down Whoever thought up that idea is not nice. While I was in the hallway, I got a glimpse of Silberstein. I saw him once on TV when he spoke on the news about migraines, so I recognized him. He grabbed my file out of the bin that the nurse had put it in and spoke briefly to her.

Once that was over, back out in the waiting room I went AGAIN. She told me it would be about 20 minutes or so, but it had to have been longer. I had time to phone my Mom who wanted an update, Howard (my hubby) read a magazine, I played a game on my phone and then I took another nap, ate a snack, used the bathroom, woke up and had a conversation with Howard before Silberstein finally came out to get us!! Up to this point, we had probably been there at least 5 hours or so. He had us go into a room and he went over my migraine history, how many a month, the types that I have, my meds and then asked my hubby to leave for a bit. We spoke about some sexual/hormone issues and he did the usual neuro tests (how many fingers do you see, follow the light, touch my fingers/touch your nose, reflexes, etc) and then my hubby came back in.

He decided for now that we are going to start with getting lots of blood work done, along with an EKG. He decided not to change much with my meds until he sees what the results are. He feels like I am doing okay on the topamax, so he decided to keep me on the 150 mg. I told him the Imitrex isn't working and he told me he wants me to try staying on it, but he said he wants to turn it into the cheap version of Treximet. So1984? I am to take 100mg of the Imitrex along with 2 Aleve and see if that works any better. If it doesn't then he will try a different abortive, but for now he doesn't want to toss new medication my way. He also decided to add Elavil to my daily medicine as a preventative at bedtime. I am starting at 10mg and upping it every 3 days if no side effects up to 50mg. He says it will help me sleep better (I sleep like a rock already, always have) and he thinks it will help get rid of my low level daily headaches that I get. The only problem I am having since I started this med is I am constantly tired. I should be upping it tonight, but I just don't know. I have a hard time making it through the day as it is. Any time I sit still for too long I almost fall asleep... I fell asleep in the bathroom the other day, I fell asleep at the microscope at work the other day at work. It is crazy. I am just hoping it is an adjustment period. ::sigh:: The last thing he "prescribed" that he wants me to do is yoga. I haven't done yoga in six years. Big Grin I would like to join a studio, but it is just too expensive, so I am just going to have to do it on my own. He didn't seem to pleased with the amount of sleep I get each night (6 1/2 hours), but he didn't harp on it or anything. He said he wants to see me again in six weeks and it just so happens the slot for him that is open is on my birthday.

He seemed to really want me to get the blood work and EKG done as soon as possible, so we left there and went downstairs and got the bloodwork done right away. The lady who took my blood was... a little scary for lack of a better term. I had to tell her what the paperwork meant. She drew my blood just fine, but the fact that she didn't know what the tests meant scared me a bit. Then the paperwork didn't match up right. It had my name and birth date correct, but most of the other info was wrong. I kept telling her that and all she would say in her Asian accent was "Are you not Ashley Carter? 5/21/1984?" This went on back and forth for like 5 minutes and finally she went "Ohh... thank you" and she used the paperwork anyway! The paperwork had my name, birthday, migraine and some of my meds, but the rest was wrong... my weight was off by 50 pounds for crying out loud and there were 5 medicines on there I have never heard of. I have no idea what or who was on that sheet. Confused

Then we left that building and went a block down the road and waited there for two hours just to get an EKG done. Good grief that took forever for a test that takes 30 seconds. Evidently, they just have too few rooms in that center. By the time that was all said and done, it was going on 2:30 in the afternoon and I was exhausted and getting grouchy. On our way back to the parking garage, I stopped and got a chai and a yogurt parfait at starbucks and then we got our parking ticket validated at the hospital. We got back to the car and as we were leaving we realized we forgot to pay at the machine.... so we had to drive around forever to find another parking spot. Let me tell you, those are hard to come by at 2:30 in the afternoon! We ended up finding one of the last ones on the roof of the garage and we saw people down below waiting for people to back out. We went downstairs to the pay machine and it wouldn't take our ticket, so we tried the one next to it and it wouldn't take it there either! Mad So we went down to the cashier and she put it in the machine down there (which of course worked and made us look like idiots who don't know how to use a machine) and thanks to the validation, it brought the total down from $24 to $15. We then went back up to level 8 where we parked and began the journey home...

By the time we got home it was 3:30 and we still had to have his car towed to the shop (turns out it was $700 worth of fixing (when it rains it pours right?), had to get all my medicine refilled and get some dinner. I was absolutely tuckered out and I had to start my new meds and go to work the next day. Needless to say, I was DRAGGING at work on Wednesday and I had to work my second job (of course- Murphey's Law). Thanks for the advice everyone, you were very helpful. Also, AlliOOP we called the IRS and did the installment plan for our taxes!! We owed $3500 this year; between taxes, his car and Jefferson this month it was our only option. Thanks to you, I had that info already handy. Thanx


~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~

Defeat may test you; it need not stop you. If at first you don't succeed, try another way. For every obstacle there is a solution. Nothing in the world can take the place of persistence. The greatest mistake is giving up.
 
Posts: 99 | Location: Delaware | Registered: 12-12-2011Report This Post
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Picture of dragondroolHOST
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Sounds like quite the adventure, especially with the blood draw person. Make sure you mention that to the powers that be. Someone needs to get the paperwork straightened out, so that it's accurate. I would've probably refused to let her take my blood until it had been addressed and corrected. I've had my share of lab mix-ups, and I know how fun it is to try and get things straightened out after the fact. It's much better to get things handled up front, if you can.



Dragondrool
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Posts: 6478 | Location: Montana | Registered: 01-11-2007Report This Post
Grasshopper
posted Hide Post
quote:
Originally posted by OnnaBugeisha:

Also, AlliOOP we called the IRS and did the installment plan for our taxes!! We owed $3500 this year; between taxes, his car and Jefferson this month it was our only option. Thanks to you, I had that info already handy. Thanx


<--made my smile for the day> You are very welcome. Glad that the advice was helpful and you made your appointment.
 
Posts: 28 | Registered: 07-27-2009Report This Post
Grasshopper
posted Hide Post
Onna, reading about your experience makes me anxious for my appointment on July 9th!

For anyone that has had experience at Jefferson, I need your help. I am being sent out there in hopes of receiving inpatient lidocaine and ketamine infusions. I have had trials here for an hour that have reduced the severity of my NDPH by 50%. My current specialist thinks that having an inpatient infusion may finally break the cycle since 2008!

Thing is, I am coming all the way from Wisconsin, so I want to get my money's worth out of it. A woman in scheduling told me that the first visit is only a consulation, and that if I were to be considered for inpatient they wouldn't admit me for a week (something about needing a bed and getting insurance pre-authorization).
Do you know of anyone I could talk to about possibly getting admitted that same day/the next day so I don't have to fly out there twice? We all know how much our care costs, and I would love to be able to save on plane tickets.
 
Posts: 42 | Location: Central WI | Registered: 11-17-2010Report This Post
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