FFS with Drs. Kleinberger & Shih (formerly Dr. Roop Gill), Kaiser NorCal

[Michelle_P]

And, the first of the bills has arrived...  For the hospital, 9 hours of OR time and one night's stay:





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[Donica]

Oh my! That's 3 time the total amount I read about in another forum. This does go toward your annual out of pocket right? My hospital stay per day is $250 and total annual out of pocket is $4400. Thank you for sharing this and please share what happens next?

Donica.

[steph2.0]

And, the first of the bills has arrived...  For the hospital, 9 hours of OR time and one night's stay:





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Oh... wow. The quoted costs for my facial surgery are a fraction of the total gross on your bill, but with my "insurance" I have to pay it all, and go out of the country to make it even close to affordable. This was Kaiser Permanente? I don't think that's available to me.

Stephanie

[Michelle_P]

The amounts are supposedly the "usual and customary" charges. Then the HMO insurance side pays a discounted amount, and I have to pay my copay and deductible.

I'm at the Max Out Of Pocket amount already and won't owe anything additional.

By the way, that bill doesn't include the "professional" charges for the surgeons and anesthesiologist.  Yow!


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[Sarah1979]

Michelle, may I ask how you chose your FFS surgeon? I think after HRT and a bunch of electrolysis, this is the next step I'll need to take in my transition.

[Laurie]

She hasn't received my bill for services rendered covering 10 days. And I do not accept insurance!

[Michelle_P]

Post-op +21 days.

There is still a little bit of bruising, fading away.  The sutures in the mouth are breaking down, and the swelling on the jawline is slowly decreasing.  The jaw is not tender any more, but the left Masseter muscle is still a bit sore.

Here's me with a cosmetic cover-up over the bruises.



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[Michelle_P]

She hasn't received my bill for services rendered covering 10 days. And I do not accept insurance!

Uh oh...  Honey badgers!  To the ramparts!

Michelle, may I ask how you chose your FFS surgeon? I think after HRT and a bunch of electrolysis, this is the next step I'll need to take in my transition.

Drs. Kleinberger and Shih work for Kaiser NorCal, and happened to be the default surgeons for this within Kaiser.  Dr Kleinberger trained under Dr. Jeffery Spiegel of Boston, a very good FFS surgeon.  His technique makes relatively subtle changes, avoiding the obvious "You've had work done!" look.  I preferred the more subtle changes, partially as they will age better, as well as look better now on an older woman. (I'm 64)  The drawback is that he had an extraordinarily long waitlist, and was doing 40-50 FFS patients a year.

I filed a grievance and was shifted to another surgeon new to the system in the Sacramento office.  I was evaluated and put in the queue to be scheduled in a few months when the doctor suddenly left Kaiser.  With all of the Sacramento doctor's patients left hanging, Kaiser granted Dr Kleinberger more Operating Room hours, and added many patients, including me, to his queue.  I was scheduled for August 28, 2018, much better than the old estimate of mid-2019.

[steph2.0]

She hasn't received my bill for services rendered covering 10 days. And I do not accept insurance!

But I've heard that you do accept alternate forms of payment...


Stephanie

[Faith]

But I've heard that you do accept alternate forms of payment...
Stephanie

Fridge Chocolate !!!

You know, when you're scrounging around the house and can't find any. You look on top of the fridge and there is that bit of leftover chocolate with the wrapper all peeled up and waving. Who cares if it's a little whiter than it used to be. That chocolate is worth it's weight in gold ... well, maybe not, but still ..

[Michelle_P]

But I've heard that you do accept alternate forms of payment...


Stephanie

[Faith]

I just gained 10 lbs

[Laurie]

I just gained 10 lbs

  Not really Faith. Her servings will only add 3lbs.. If I dished it up you might gain 15....

yes they were good.

Hugs,
  Laurie

[Donica]

IDK Laurie? That looks like a sufficient form of payment to me. Fit for an Angel.

[Donica]

Oh, I just realized that bottom picture is a <<<<PIZZA>>> .

[Veronica J]

And, the first of the bills has arrived...  For the hospital, 9 hours of OR time and one night's stay:





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Holy , my gah.. and no surgeon costs.. hmm this is gonna be tougher than i thought.. i have a budget less than that .. and wow.. just plan wow.. surgical costs certainly have gotten out of control in USA/NA

[Michelle_P]

Holy , my gah.. and no surgeon costs.. hmm this is gonna be tougher than i thought.. i have a budget less than that .. and wow.. just plan wow.. surgical costs certainly have gotten out of control in USA/NA

Oh, this isn't the actual cost anywhere sane. These are the mythical ChargeMaster prices, not the actual agreed insured rates, or what a good FFS surgeon would have already negotiated.

Hospitals have something that they call internally the "Saudi Prince Problem". If an insanely wealthy person were unexpectedly admitted, what rate could be charged to soak as much cash as possible from a patient?  Seriously. Hospital administrators live in an interesting world.

The actual rate is negotiated between insurers and the hospital, or the independent FFS surgeons and hospital. This is much lower than the ChargeMaster rate.

Finally, I am already at the Max Out Of Pocket level for my insurance, so I won't be on the hook for copay or deductibles. Everything done is covered by insurance except the blepharoplasty on the left eye. (I wanted them even!). I paid that before I was admitted.

I did have quite a bit of work done but the charges from the better known FFS surgeons for all of this would be around $42,000 to $62,000 without insurance.


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[Veronica J]

Oh, this isn't the actual cost anywhere sane. These are the mythical ChargeMaster prices, not the actual agreed insured rates, or what a good FFS surgeon would have already negotiated.

Hospitals have something that they call internally the "Saudi Prince Problem". If an insanely wealthy person were unexpectedly admitted, what rate could be charged to soak as much cash as possible from a patient?  Seriously. Hospital administrators live in an interesting world.

The actual rate is negotiated between insurers and the hospital, or the independent FFS surgeons and hospital. This is much lower than the ChargeMaster rate.

Finally, I am already at the Max Out Of Pocket level for my insurance, so I won't be on the hook for copay or deductibles. Everything done is covered by insurance except the blepharoplasty on the left eye. (I wanted them even!). I paid that before I was admitted.

I did have quite a bit of work done but the charges from the better known FFS surgeons for all of this would be around $42,000 to $62,000 without insurance.


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thats better, i am not covered here for any of that.. soo all out of my own pocket.. and like my max is arou d 60k all up for FFS..

[Michelle_P]

One month post-op, the bruising has almost vanished and the swelling is definitely reduced.

Things will continue changing slowly from this point on.



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[Michelle_P]

Here is a composite image of my pre-op appearance with my one month post-op (no makeup) images.  This might make studying the details of the surgery's effect easier.



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