Orchiectomy cost and concerns

[Chris8080]

Okay, the bill is not here but my summary of payments from bcbs arrived. It looks like:

The grand total was $4,469.75 (The operating room was $3,044 of that).

Insurance pays $2,681.85

I pay $1,787.90

I could live with that, not a want to but it's doable. I check every day and nothing has shown on the online statement yet but their history is at least two months before any office visit co-pays or money due shows up. If that holds true for the surgery and hospital it'll be late November or even December before I know anything. With my luck I'll get a Christmas greeting from them that says . . . Surprise and Merry Christmas. 

[Dee Marshall]

I don't think there is a stock one size fits all answer to a pain level, seems everyone is just so different as are the surgeons that perform the surgery. I experienced no pain to speak of other than some minor discomfort but in my case the testicles were pretty painful for the last several years and any discomfort from the surgery was actually less than what the testicles caused 24/7. My surgeons only advice post op was no heavy lifting, no soaking in a tub, spa or pool for a couple of weeks. He advised a couple of showers a day starting on the day of surgery to help keep it clean and prevent any possible infection. Other doctors recommend no showers for 3 days. On the evening of the day of surgery I went for a couple of long walks and it was not only quite comfortable but a wonderful feeling with the evil twins not there.

It took 8 days but the stitches are finally starting to dissolve and with that there is a very small amount of blood spots. Kind of like little pin points where the stitches were.

I was on both spiro and Finasteride and as luck would have it both scripts were due for refill about a week before the surgery and my MD said to not re-fill either of them. Fine by me, I have no idea if I'm right but I blame both of those drugs for a continuing decrease in any sexual sensations. Didn't bother me much for down below but losing nipple sensation is pretty devastating for me. Off those two drugs for a couple of weeks now and some sensation has returned so maybe I was correct about the reason.

As for your question on prostate function that's a question for your Urologist and I wish I had gotten a little more time to discuss that. I had great hope for the enlarged prostate shrinking after surgery. Before surgery best I could hope for is two hours sleep at a time and off to the pottie. Starting on the day of surgery I was up every hour on the hour to tinkle.  9 days since surgery now and the last couple of nights I went 4 straight hours of sleep before tinkle time and that hasn't happened in several years.

I hope some of this helps ya out JennyBear, good luck and let us know how things go for you.

Chris are you sure the 2 hour thing was the prostate? Spiro does that to me.

:

April 22, 2015, the day of my first face to face pass in gender neutral clothes and no makeup. It may be months to the next one, but I'm good with that!

Being transgender is just a phase. It hardly ever starts before conception and always ends promptly at death.

They say the light at the end of the tunnel is an oncoming train. I say, climb aboard!

Think outside the voice box!

[Chris8080]

Chris are you sure the 2 hour thing was the prostate? Spiro does that to me.

No, not sure. Best I can say is that I was only on the Spiro this year and the pottie breaks all night have been going on a lot longer than that. Maybe the spiro was making it worse but I dunno, could be huh? Starting the night of surgery it was worse than it's ever been getting up every hour on the hour but that seems to have stopped now. Thinking possibly swelling from the surgery but that too is a guess on my part. My post-op appointment with my surgeon is in less than two weeks and I do plan on asking him about this.

[Chris8080]

Oh my. Yikes . . . Title of this thread is orchiectomy cost and concerns but maybe it should be - Concern over the cost of orchiectomy?

They have posted the costs on their online statement and it is shocking to say the least. First it's pretty tough to decipher and figure out just what they are saying. There is no info regarding insurance, not paid/pending/denied, just charges so I can only assume they either haven't yet charged the insurance or haven't heard back from them.

What's confusing is that there are three separate charges with a total of $7948.80 
Then there is a line that says payments/adjustments of $4,019.96
A charge for a doctor I have never heard of for $42.00 (curious)
Another charge of $1688.00

All three of the charges are listed only as "Professional Services". Nothing broken down as to what the charges were for such as surgeon, operating room, anesthetics etc. If they did give an adjustment of over $4,000 why not list it as what the balance really is? A $42.00 doctor charge? I don't know a doctor that would cancel an appointment for $42 but maybe that was for the cookie I was supposed to get. 

Near as I can figure out right now the total is $3928.84 (I think) and primary insurance should cover 80% leaving $785.77 for Blue Cross/Blue shield. Can't say for sure yet that insurance will cover any of it which would leave me on the hook for the 4 grand. Yikes! Insurance has paid everything so far but as of right now I can't say the surgery will be covered. If the insurance denies the claim I will of course pay it but not right away, I'll let the hospital billing department duke it out with the insurance first to see if they can get any of it covered.

Bottom line is that so far I only know what I think the total is and nothing else.

Healing up has been uneventful. Still getting a few tiny pin points of blood that I think is from the stitches dissolving. No pain, what minor swelling there was is long gone. Only new development is minor itching along the line of stiches.

[Tessa James]

Oh my. Yikes . . . Title of this thread is orchiectomy cost and concerns but maybe it should be - Concern over the cost of orchiectomy?
They have posted the costs on their online statement and it is shocking to say the least.

Congratulations on getting there and then the medical $$$ mess begins.  IMHO a for profit medical system such as the US ensures is rife with opportunities to make a buck and for patients to get the sticker shock.  I had a 35 year career in the system and know that many relationships between providers, hospitals and clinics is all about the $.  That extra MD charge could have been for the pathologist who ascertained that yes, those were actually testicles they removed or to simply review the chart.  Some day we will evolve and the sooner the better that we recognize all health care as a right and not the privilege it is today.

[Devlyn]

Tomorrow is five weeks out from surgery. The incision has disappeared in the scrotal skin. There is a small lump under the skin on the right side, but the left side has retracted nearly flush to my body. I'll be very pleased if the right side follows suit. There is a very faint shadow of the falling blood in my right leg. My mental and emotional state is on the rebound. Dealing with the uncertainty (and the blood) was wearing me down. I'm back to my long walks, looking svelte, and loving life. Oh, and causing mischief! 

The first actual bill arrived today, from the anesthesiologist. The charge was $1,120.00, insurance paid $942.84 and I pay $177.16

I'll get all the numbers start to finish into one post when the dust settles.

Hugs, Devlyn

[Ashley3]

Tomorrow is five weeks out from surgery. The incision has disappeared in the scrotal skin. ... I'll be very pleased if the right side follows suit. ... My mental and emotional state is on the rebound. ... I'm back to my long walks, looking svelte, and loving life. Oh, and causing mischief!  ... The charge was $1,120.00, insurance paid $942.84 and I pay $177.16

Hey Devlyn, really cool, congrats dear (mischievous) one!   ... so happy for you... and insurance coming through for you makes me feel good as if it were my bill... I just love seeing when it actually covers stuff, you're very fortunate with your plan. Overall inspiring... I need to get out for some long walks! ... big hug, Ashley

[Chris8080]

Great news Devlyn & thanks for the update. I've always heard about the shrinking scrotum but at 2 weeks one day I'm still in waiting mode on that. You must be really happy that all that bruising is nearly gone. You didn't mention the swelling so I assume that is gone? Great news also that your insurance came through, I'm in waiting mode on that too. I have absolutely no reason to believe my insurance won't pay, they have paid everything else so far but what would life be without something to worry over?

My online statement has been updated, it now includes the anesthesiologist charge of $680.00 added to the total bringing the total to $4608.00 after the adjustment down of $4019.96. Next column says payments received $0.00 and patient responsibility $0.00. I don't know if they have yet to bill the insurance or haven't yet heard from the insurance. Took you 5 weeks to get your co-pay, this hospital has been slower than that taking 2 months+ to post co-pays on office visits. Also strange is that my insurance says co-pays for office visits are $15 but I get co-pay bills like $6.50 or $9.35 etc.

[Leslie601]

Congrats, so glad you're doing better!

Leslie

[Devlyn]

Thanks, Leslie!

Last night the gun was fired for the first time in about five weeks. All systems go, I even had a partial erection. There was a small amount of ejaculate. Reports are it was salty. 

Hugs, Devlyn

[Megan.]

Thanks, Leslie!

Last night the gun was fired for the first time in about five weeks. All systems go, I even had a partial erection. There was a small amount of ejaculate. Reports are it was salty. 

Hugs, Devlyn

Brilliant,  and thanks (I think) for the descriptive detail! X

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[Leslie601]

I assure you that will stop. It did for all my trans friends at some point. Especially when on high E. Arousal still occurs for me even after Penis removal although it's a bit early to see if Orgasm will occur.

L

[Ashley3]

Congrats Ms. Devlyn... so happy you are happy... and functioning!

[Devlyn]

Statements and bills keep rolling in. Today the payment statement from insurance indicates that Dr Oates charges are $2,530.00 and I am going to pay $279.43.

So, by my estimate it's

$310 for two psych letters  (I paid $120)
$75 for surgical consultation  (I paid $75)
$2,530 for the orchiectomy (I paid $279.43)
$1,120 for anesthesia  (I paid $177.16)
$3,044 for the operating room  (I paid $1787.90)

$7,079 total.  (I paid $2439.49)

Somewhere in there they hid the charge for those cookies! 

Hugs, Devlyn

[Megan.]

$2400 seems steep for cookies,  I hope they were good!

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[Chris8080]

For those wondering about the costs for an orchi here is the hospital billing breakdown of charges for mine. So far no word from Blue Cross/Blue Shield and even if they thumb their nose at me I'll be on the hook for $1224.99. This doesn't mean Blue Cross/Blue Shield won't pay, just means it hasn't shown up on my account detail yet. It still shows my balance as zero, nothing owed by me. Normally takes about 2 months with this hospital billing for my co-pays to show up and it's been 4 weeks as of today.

Hospital Encounter Surgical Services - Main OR on September 28
6,218.80
Primary Ins Payments and Adjustments -1,759.06
Primary Ins Payments and Adjustments -4,010.99
Blue Cross/Blue Shield balance 448.75
Patient balance 0.00

Hospital Encounter - Main OR on September 28
SURG PATH,LEVEL II - 42.00
Primary Insurance Payments and Adjustments -11.05
Primary Insurance Payments and Adjustments -28.13
Blue Cross/Blue Shield balance 2.82
Patient balance 0.00

Surgery Visit - Main OR on September 28
REMOVAL TESTIS,SIMPLE - 1,688.00
Primary Insurance Payments and Adjustments -366.20
Primary Insurance Payments and Adjustments -1,228.38
Blue Cross/Blue Shield Balance 93.42
Patient balance 0.00

Anesthesia Visit / Surgical Services - Main OR September 28
ANESTH,MALE GENITALIA SURGERY - 680.00
No insurance payments made as of 10/25/17 Balance 680.00

Total Patient Outstanding Balance: $0.00

[Chris8080]

Update on the billing. The primary insurance has now paid all but $38.34 of the $680 Anesthesia charges. Blue Cross I suspect is just plain slow which would account for the normal 2 months for co-pays to show up on my billing statement. Total unpaid as of this morning which now also includes the post op office visit and waiting on Blue Cross is $687.33. Once Blue Cross finally pays and they have on everything so far, just slowly, I should be left with only my normal co-pays which should be well under $100.00 out of pocket for me.  There were other costs, Monday thru Thursday in a hotel, gas money, some eating out etc.

[Chris8080]

The orchi was 6 weeks ago this morning and so far nothing has changed on the online billing statement. It still shows -

Insurance balance $669.53
Patient balance $0.00

The insurance balance now includes the post-op office visit at 3 weeks after surgery. I think the co-pays should show up in another 2-3 weeks. With 5 separate charges on the statement co-pays will most likely be on all 5 and I estimate probably around $50-65.

[Chris8080]

7 weeks yesterday since surgery and the insurance is finally coming through. Primary insurance paid their share a few weeks ago and now secondary insurance Blue Cross is paying also. 4 separate hospital/surgery charges and so far Blue Cross has paid on two of them leaving the surgery unpaid insurance balance as follows.

Insurance balance $2.82 (Professional Services)
Insurance balance $32.34 (Anesthesia)
Patient Balance $0.00

Everything else has been paid and the online statement isn't even showing a co-pay. Yet. Can't describe what a relief it is to not have that bill hanging over my head, almost as good as the evil twins being gone. Well ok, not that good but really good.

Had the post-op appointment with the surgeon 3 weeks after surgery. This doctor was quite reluctant to do the surgery at all and he didn't schedule a surgery date until I had given him 3 letters but this hospital does have a gender clinic so reluctant or not he did it. First thing he asked about was post-op pain/recovery and any issues or regrets. I told him that a couple of hours after surgery I walked out of the hospital with less pain than I had walking into the hospital and he just beamed. Seems he thought he had made a terrible mistake cutting them off. I told him no, that he literally saved my life and the only thing if I had the chance I would change would be to have done it a few decades sooner. Doc seems happy so hopefully the next orchi they send his way will have a little easier time getting the surgery date with him.

As for recovery time for me there just wasn't any. No pain, no bleeding, very minor short lived swelling and very minor short lived bruising. I walked out of the hospital the same morning as the surgery and went on with my life one very happy camper.

[Faith]

that's great Chris, I look forward to the day ...

I really hope my insurance accepts it when the time comes. I do know that when it is time it's going to happen no matter what.