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Alcohol Ablation

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  • Alcohol Ablation

    [Alcohol Ablation]

    Author: Cindy Hughes (---.monroe-guaranty.com)

    Date: 06-13-02 18:49

    Two questions here. I have been approved for alcohol ablation by Dr. Spencer at Baylor Heart Clinic but my insurance won't pay due to it being out of network (I am on an exclusive network plan). The insurance company has referred me to a Dr. in Indiana who has done only 3 of them which makes me very nervous. I've always been told that there are no HCM experts in my area (Central Indiana).

    1 - Where are the referral centers for HCM? I know of Baylor, Mayo, Johns Hopkins and Cleveland Clinic. Are there others in the country? I'd like to try to find someone that might be in the network that has more experience.

    2 - Which facilities perform this procedure?

    I'd be interested in hearing form anyone with information above or who has had this procedure performed in the Midwest.

    Thanks

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    [Re: Alcohol Ablation]

    Author: Lisa Salberg (---.dyn.optonline.net)

    Date: 06-13-02 20:43

    Hello -

    1- Minneapolis Heart Inst. Minn. MN - Mayo Clinic, Rochester MN< St. Lukes, NYC - Boston, MA - Cleveland Clinic Cleveland, OH

    Are the ones I would stick with for specialty center

    2.All of the above are preforming the procedure at this time - Mayo and Cleveland have the highest # of myectomy's per year and have great outcomes, I only mention this because if you do not have a good vien in your heart to place the alcohol in the procedure will not give you the relief you seek and surgury may be your next step - better to be where they can do it rather then packing up and moving cross country -

    Best wishes,

    Lisa Salberg

    HCMA

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Alcohol Ablation]

    Author: Board Moderator--Sarah Beckley (---.dsl.mindspring.com)

    Date: 06-13-02 20:55

    Dear Cindy

    I think you should appeal your HMO's decision. Ask Dr. Spencer to write a letter for you and maybe there are some statistics you can show the HMO that you should be seeing someone whose done more than 3 procedures. You will need to contact the HMO to find out their appeal requirements. Furthermore, you should find out what the hospital would charge you if you decided to self-pay---they frequently discount their services substantially if you tell them you are going to pay out of pocket and right away.

    Best of luck,

    Sarah

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    [Re: Alcohol Ablation]

    Author: Lisa Salberg (208.47.172.---)

    Date: 06-14-02 11:09

    Dr. Spencer and his staff have been successful in the past with insurance companies, I am sure if you ask he will help. However in my experience when the ins. co has found an alternative person for you, they rarely want to hear anymore on the topic...HOWEVER... You do have rights under the Patients Bill of Rights to dispute the case to an outside pannel for review. If you would like more information as to how to do that please call and set up an appointment - - - it is far to detailed for the message board.

    Best wishes,

    Lisa Salberg

    HCMA

    973-983-7429

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Alcohol Ablation]

    Author: Jerry Salzman (---.indy.rr.com)

    Date: 06-14-02 15:55

    Cindy,

    I see doctors at the Care Group (St. Vincent's) in Indianapolis. I know they are doing alcohol ablation which I may need to consider. I haven't talked to the doctor who does the procedures but my cardiologist thought they had done 10 - 20 procedures.

    Jerry

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    [Re: Alcohol Ablation]

    Author: Patricia Grall (---.dwave.org)

    Date: 06-14-02 20:22

    Dr. Fred Leya does them at Loyola University Hospital in Chicago. Contact Trudy his nurse at 708-216-4225. I just had mine done there. I was his 19th ablation procedure. He has one four more since then. I can give you more information on this if you want to cantact me at 715-842-2033.

    I am very gald I have done this and am feeling better after only four weeks. He feels I will have a great deal more improvemnt in the near future. I also have an ICD III and am very greatful for that. That was done by Dr. M. Burke at the same hospital three days later. I am very pleased with both doctors and their staff. The hospital is also a very good hospital. I am a Nurse and believe me I spent alot of time researching this prior to doing it.

    My intentions are to write more about my experiences with more backgroud data in about two weeks. By than I will have more information.

    Good luck and I hope this helps.

    Patricia Grall

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Alcohol Ablation]

    Author: Patricia Grall (---.dwave.org)

    Date: 06-14-02 20:24

    An Additiion to my note. Dr. Spencer at Baylor Heart Clinic trained my Dr. Leya at Chicago to do this ablation procedure.

    Patricia Grall

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    [Re: Alcohol Ablation]

    Author: Cheryl Farris (---.dsl.hstntx.swbell.net)

    Date: 07-23-02 16:52

    Cindy,

    If there is any way to appeal to the Insurance company, I would do it. Dr. Spencer gave my husband his life back almost 5 years ago. His gradient was 100 at the time of the Alcohol Ablation. He could barely walk from the bedroom to the bathroom without being completely out of breath. My husband did have to have the procedure done twice, the first time they got his gradient to about 60. He felt better, but wanted more. About 6 weeks later Dr. Spencer did the procedure again and this time with fantastic results. A gradient of ZERO. To this day his gradient is still 0. He is off of all medications. Had it not been for Dr. Spencer, I don't know where my husband would be today. My husband was patient #31 almost 5 years ago. My sister in law had the procedure done 3 months ago by Dr. Spencer and is doing great. I forget what number she was, but I know it is well over 100. She is from Colorado and it took her about 2 months with her insurance company before everything was said and done and they agreed to pay. Keep trying and God be with you.

    Cheryl
    NOTE: This is a post from the previous forum message board.

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