bumped for skierchik Denver FFC

Discussion in 'Fibromyalgia Main Forum' started by Bailey-smom, Nov 9, 2005.

  1. Bailey-smom

    Bailey-smom New Member

    My pain has been increasing in the past 6-8 months. In the past 7 years I have had pain in my back & legs but it is now going into my upper back, chest, neck, shoulders and arms as well. A few months back I was diagnosed with FM and I do have great Drs that are willing to help me but I am very impatient. I want to stop hurting – yesterday:) Or sooner:)

    I have problems accepting the pain in my arms and legs and the extreme fatigue that is coming with this dd! I find it hard to want to do the things I loved to do in the past and my family and my business are suffering.

    I have seen many posts about the work done at the FFCs around the US and have read the info about them on this site many times. Yesterday I finally broke down and called to request an info pack at the Denver FFC as that is the one that is closest to me – 9 ½ hour drive.

    Has anyone been to that particular facility? The woman who answered the phone seemed very nice. I asked how they scheduled appointments if I were to drive from so far away – could I schedule more than 1 appointment over a multi-day visit. She said that the blood work & IV would be given the first visit and that I could have another IV the second day before I leave for home if I wish. She said that I could have phone appointments in the future so I would not have to make the drive every time. She is sending hotel info in my packet as well.

    The only thing that stinks is the fact that they do not file insurance. The only reason I say that is because my company would actually pay more of the cost if I did not prepay. I am taking away my companies “bargaining” rights by paying the bill even if the FFC did not lower the price so my out of pocket is actually more by prepaying. Augh!!

    My fear is that I will not hurt when I walk in the door of the FFC – how ridiculous is that??? I know it will not be that way but have you ever had that happen? Or I wonder if I hurt enough to go to a place like that? I wore windpants to my office today because I hurt so bad that I did not care – so I know that thought is also crazy. But weird thoughts are just flying through my head.

    Kelly
    [This Message was Edited on 01/06/2006]
  2. abbylee

    abbylee New Member

    Life just sucks sometimes, doesn't it?

    I've not been to one of those facilities yet as I'm afraid it won't work, and I'll be out even MORE money on another wild goose chase.

    A lot of us are hurting more this year, or so it seems, so I'm just trying to get through it.

    Have you asked them about any kind of payment plan so that maybe you could work round your insurance requirements?

    abbylee
  3. karatelady52

    karatelady52 New Member

    They will send you a long information packet for you to fill out. Most of us don't look like we're hurting but the great thing about the FFC's is they know that.

    I can tell you my experience with crazy thinking. I was finally diagnosed with lyme disease and 3 viruses from the FFC Atlanta. I've been on a lyme forum and they talk on there extensively about how lyme/viruses cause a lot of wild thoughts to go on in our heads. We seem to have fears about everything. Just knowing that has helped me to relax and stop stressing over every little thing.

    I don't know if your problems will be bacterial or viral but I do know that these centers will help you find the root of your problem and you won't have to live with it for the rest of your life.

    I think Cindycor went to the one in Denver.

    Sandy
  4. Bailey-smom

    Bailey-smom New Member

    and I think he may even be interested for once. He is getting real tired of the new pains - the past 7 years was hard but I was able to keep going. Lately I have been exhasted.

    So with him on my side for once it may be OK - I just don't know if I want him to go with or not. I kinda' do and kinda' don't - I'm a bit independant and he would have to miss work. It's not such a big deal for me - I work for myself but he has employers & would have to use vacation time.

    I don't know.

    Kelly
  5. TwinMa

    TwinMa New Member

    I’ve been to the Denver FFC

    I have mixed feelings about the Denver FFC. I had a rough start with them and they are still trying to make things right. To their credit, they are trying pretty hard. It’s a long story, and I still haven’t figured out how to post it all. I will at some point.

    One thing I can say is that they tend to overbook. I just had my third appt with them yesterday. My appt was for 3:30, and I didn’t see Dr. LaBair until 5:00. I understand that doctor offices can run behind, but I had to be home by a certain time and it became a problem. The good part was that Dr. LaBair spent one hour with me instead of the ½ hour appt that it was booked for. And I still only got charged for the ½ hour ($165). I guess that’s why she tends to run late. (Unfortunately, it made me even more late!).

    Since you are coming from South Dakota, this may not be an issue for you. You will just be hanging around their offices for two days no matter what! They run late on phone appts, too, though, so that part may affect you.

    Another thing you should be sure of is to know what your costs are up front. The shocker for me was the blood test costs. I had seen in print the costs of the appts., the range for supplements, IV’s, etc. I never saw anything in print about the actual cost of the blood work and no one offered this info. In retrospect, I was stupid for not asking how much it would be. Darn fog!

    They told me they would run it through my insurance, so I thought I was okay. My insurance is an HMO type, and they denied it due to not getting prior authorization. This was my fault for not checking into what my insurance would cover. Bottom line: Blood tests were $3200. Ouch. So it was partly my fault for not asking the right questions, but it was partly their fault for not disclosing this up front. FFC does have payment plans, and you can talk to them about financing this expense. Just know what you are getting into.

    Another thing I would recommend: Take a tape recorder! Especially for the second appt. That is where they explain what is going on with your blood results. I took one yesterday, and I’m really glad. After a while, your brain just can’t take any more in. I’m glad I’ll be able to listen to it again. I’ll probably do a mini-transcription of the highlights so I make sure I have documented all the info she talked about.

    All this happened before I found this board, too. I have learned so much since joining this board. Kelly, you should be going in with your eyes more wide open just because you have this phenomenal resource. Read all the FFC posts. I’m sure you have already. Most are pretty positive. That is the reason I’m continuing. Although I am still looking for any and all alternatives all along the way.

    As far as if it has helped, I still don’t know. It’s too soon to tell.

    What I do really like is that I have all these blood test results that show what is really happening with me. That is a very powerful tool on its own.

    And don’t worry about not feeling “bad enough” on the day you go in. This DD is around whether you are having a good day or a bad day. It’s actually better if you are having a good day, because you’ll take in more information.

    Gee, even though I didn’t get into my big long saga, this was still a big long saga! Sorry so long!

    Good luck Kelly! You’re lucky to have a supportive hubby, too. That helps!

    Katy
  6. jane32

    jane32 New Member

    I think you will happy. They do have a great payment plan through care credit.
  7. TwinMa

    TwinMa New Member

    I wanted to say something else about the Denver FFC.

    All of the people there are very, very nice. They are all friendly and helpful and they sincerely want you to feel better. They all know what you are going through.

    Donna is one of the physician assistants, and she has FM and has had it for years. She may have CFS, too, I'm not sure. She is Dr. LaBair's sister. She has always been very up front with what has and has not worked for her. She does the initial blood pressure, pulse, weight, etc. She is really great.

    After I re-read my post, I thought it came across pretty negative, and I don't want to discourage you from going there. I have had some negatives, but have had some positives, too. For me, the jury is still out.

    Katy
  8. Bailey-smom

    Bailey-smom New Member

    Don't worry about them sounding good or bad - I need your whole experience:) I am just not used to not being able to "shake off" the hurt and move on or take a pill and move on. Even after 7 years it hasn't sunk into this big Irish head yet - it's got to be the stubborness. lol

    If anyone else has gone to Denver please reply as well!

    Kelly
  9. orachel

    orachel New Member

    First off...I've not been to the FFC yet. But I have 0 doubts of their utter and complete help with these DD! I know many many people who have been assisted.

    Few things...first, I have aetna ppo...I don't know what you've got,obviously. But I have an aetna rep I've befriended, and she's amazing. I got my info packet (I'm only waiting for the first of the year to find someway to pay for it...though they do have carecredit credit card...and also so my "out of network" deductible will be met for the whole calendar year. No reason to blow $750! LOL) and read a description of each and every visit to my aetna rep. She looked up what they would most likely "categorize" each visit as # wise, and said that the costs for each visit, even the first 2 which are mondo pricey, are within what they consider "fair and reasonable" pricing for such a lengthy visit. This means that they'll reimburse me 60% no problemo, whatsoever after I pay the 750 out of network deductible for the year. But also...In light of the fact that FFC takes SUCH a different approach to treating these DD than the medical community at large, she told me I actually have one heck of a shot of petitioning Aetna to make them pay 90% (and treat FFC as In network!...of course, will still have to pay out of pocket and be reimbursed!) because of "network inadequacy".

    Ie: I need to have a Neuropsych evaluation to measure my brain fog. There's a specific neuropsychologist my doc wants me to use...She's not in network (which means I'm paying over 1000 out of pocket, easy). However, there are NO neuropsychologists in my network in my area....So I got the docs office to contact Aetna (different department than the normal one) and they approved the doc I wanted for any treatment for one entire year. The logic is that WE (as patients) cannot be denied the RIGHT TYPE of physician or medical care as a result of the inadequacy of Aetna's network of physicians....

    So, based on that, she (the aetna rep, who would totally get fired if they knew she shared all of this insider info with me!)...thinks I've got a very good chance of petitioning Aetna that they have NO care providers who offer the same services as FFC...and she said It also helps significantly to show them how they (the insurance provider!) will make out like bandits financially.

    IE: In the last 5 months since I first got sick, Aetna has paid more than $10,000 of my medical bills....I've seen over 15 docs and specialists, for over 50 doctor appointments in that time. Also, during all of this 10k of medical care, my medical condition has done nothing but worsten....Ie: they will end up paying over 20k per year to "maintain" my current level of bad health, or a detoriation. If they approve FFC as in network, and reimburse me 90%, then I have a much greater chance of improving (must send aenta their brochure, testimonials from patients who's medical status has been vastly improved...anything that helps make your CASE!) and thus Aetna will get off much much cheaper overall as once I reach a remission, or improve significantly, chances clearly show that my medical bills will REDUCE DRASTICALLY!

    So, I know I wrote you a book here...but if you can figure out a way to MAKE them pay, based on current laws, you've got a much better shot! Also, you've been sick for much much longer...I've only been bad for 5 mos...Imagine how much more compelling your case will be! All of the expensive bloodwork direct bills to your insurance, so that's good. The only other expenses are IV therapies and also supplements. Supplements....you're pretty much stuck paying for those. As for iv therapies.....My aetna girl said that they WILL Pay for IV therapy if you get them through an in network provider. So all you have to do is work something out to BUY the iv from them and have another doc (good you have a good relatinship with your docs...I don't!) administer it, or if something normal like a Meyers Cocktail that's available all over, FFC might be able to work with your providing doc and just tell him what IV's he needs...and then docs office direct bills.

    So, my point her is you have a TON of options.

    Also...I know what you mean about suddenly having symptoms stop the second you walk into a docs office...only to start again when you leave.AARGH! I call it the Murphy's Law of Medicine. But its my understanding that you flat out dont have to feel that way about FFC. They know you're not faking or putting one over, hon....curing these DD is all they do! So don't worry about that/

    However...wanted to let you know just so you're prepared for it....whenever you're using antivirals and herbals, you often feel mighty worse for a brief interval before you get better...its commonly referred to as Herxing. Only reason I told you is you mentioned you wanted to feel better yesterday (don't we all! LOL), and I didn't want you to feel crummy and stop treatment at FFC. It does take a few mos to start feeling better, according to everyone I've spoken to about it...but then you really get better!

    So...As for your ins co's bargaining rights....according to Aenta's list of allowable charges, and they're a big insurance provider...they're costs are well within the limits. Fight your ins provider on this! FFC will give you a "superbill" which gives you the coding you need to send for reimbursement. If you compare Just an office visit....nope, wayy to expensive. But if you use the code for an extensive history and first visit and treatment....well within their limits. So once you get your superbill, they may change their tune on that. If not, fight it tooth and nail.

    And finally, no better way to get your questions answered than going to the horses mouth. FFC's offer a free information night...i know you're a ways away, but if you're really worried, might be worth the trip!

    Good luck!
    Let us know how you do! I'm so excited to start myself...herxing be darned! LOL...I'm a train wreck right now! LOL

    Rachel

  10. dancingstar

    dancingstar New Member

    First, Bailey's-mom, I went to FFC LA the other day, and my symtoms weren't that bad on that day...no problem. My temperature was still only 97.4, and it was obvious I didn't feel super even if I wasn't at my worst. Try to not worry about that one.

    Rachel, Thank you for the Aetna information. I have a Blue Shield PPO, but I am wondering if I should try something similar. It was really sweet of you to post this as it could be very, very useful to many of us!
  11. orachel

    orachel New Member

    I've been meaning to type that whole huge book out one of these days...today pain is so bad, but for some reason I can concentrate through it, so I'm keeping myself busy and distracted with marathon typing sessions. If I can focus on one thing...seems to make the pain a bit better! LOL

    I know this info is astounding. The whole conversation with my new buddy at aetna I was going "NO!" "YOU"RE KIDDING!!!"...in never occurred to me that anything like that was possible. Maybe I should cut and paste it into a new thread, but kinda running out of steam right now! LOL

    Glad it helped you....I know many of them operate with much the same business plan. Trick is to figure out how their "network inadequacy" plan works, or whatever they call it, before you tell them why you want it....Just say you want to see a rheumy out of plan, and keep asking questions. Also, when you call them WRITE DOWN who you got info from and time and date....that way if you ever get different info from a different rep (thank god I got my aetna ladies home phone number...before that, every time I asked the same question I got a different answer! Maddening! LOL) you have ability to ask them to check records of your call with so and so of such and such day....often calls are even taped.

    I've figured out only way to deal with ins people is to either get midevil on their buns, or kill them with kindness. Funny, but if I really ask for help and sound desperate (no acting needed! I am desperate! LOL) I've gotten incredible things from docs or ins companies. Trick is to make them feel like they are the only person on earth who can help lil' ole you, and you just don't know what you'd possibly do without their help!

    Trust me...works miracles! And this from a woman with 14 years in sales...

    Rachel
  12. dancingstar

    dancingstar New Member

    Well, Rachel, I think you're right. Killing those insurance companies with kindness is definitely the way to go.

    I've got an idea, my sales smart friend. I read the other post about husbands and pain and will write more later cause I need to get myself dressed and out of here, but I know you're not working right now...in fact, I've got lots of ideas, but I can't really speak with you about any of them cause we can't exchange information here, can we?

    Well, one of them that is most simple involved helping me build my business. You don't need to live anywhere in particular for me to pay you a commission to help me build my business mostly in Los Angeles and So Cal. We could figure out a way to do this if you ever want to do it.

    Right now I can't really afford to hire sales reps...but I can definitely pay commision on clients that are brought in.
    Something to keep in mind for when you feel better.

    Is it against the rules to suggest this? Oh, I so hope that it isn't. Probably not the best day to bring it up, but I can tell that you'd be great at it!
    -Bebe



  13. Juloo

    Juloo Member

    I have Aetna PPO also. I had my first Atlanta FFC visit on Monday. Time to file!
  14. acesk

    acesk New Member

    Dr. LaBair is very nice at the Denver FCC but she runs late ALL THE TIME!!! I flew in from Florida the day before and had a 9 a.m. appointment and she didn't see me till lunchtime! I didn't get out of there till 4 p.m. after an IV, so don't make any plans that day! My 2 phone appts afterwards - late each time by at least 2 hours!!

    I didn't finish up the protocol because I had no relief after 4 months (and spending a lot of money). I wish you luck.

    Sue in Florida
  15. dancingstar

    dancingstar New Member

    I think it is really rude to not see a patient that flys in from Florida for a 9:00 appointment until noon no matter who you are or what you are doing for them, especially a fibro patient or anyone that is in pain.

    I don't think that Dr. Holtorf would be thrilled to know that she is keeping her patients waiting THAT long. That's just not right...unless there was some kind of medical emergency that she was dealing with.

    In Los Angeles I was seen about five minutes past my appointment time, and they apologized for keeping me waiting.
  16. Bailey-smom

    Bailey-smom New Member

    and he said I should fax him the fee schedule when it comes and we will go through it. I am the agent so it is easier to understand what the ins and outs are of the policy. What I worry about the most is the fact that when I pre-pay I will be responsible for any amounts over and above the usual & customary charges.

    Normally if a dr office bills insurance and the fees are greater than usual & customary I would just sign a form for insurance giving them the go ahead to discuss the charges with the provider. If the provider will not go down on the pricing structure then the insurance will pay the remainder. Since we have to pre-pay here that does not apply and the charges above the usual amount would be my responsibility.

    Isn't there always a hitch?

    Thanks for all the great info!

    Kelly
  17. orachel

    orachel New Member

    Per aetna...normal and customary charges....

    FFC's charges for visits are well within normal and customary amounts they would negotiate. Assuming your company is similar in terms of their definition of normal and customary, you should be ok.
  18. hubby

    hubby New Member

    I tend to not take care of business because though I know I can it is time consuming and if I am not thinking on all eight plugs it is pure hell. Thus is insurance without the disease and trying to live a life etc with Dr and medications, and others.

    I am wondering after all that with insurance, I just have Medicaire right now, and am just trying to get up enough nerve to tackle what the supplemental plan for prescription socverage will actually do for me by the 15th deadline, little lone try and figure out what Medicaire pays or not.

    I reside outside USA so assuming if I had a serious problerm would enter the US only 3 hrs away, as I say that, I used to mean that, but now it is "IT IS # HRS AWAY!!!" Don't know if I can make it that long anymore.

    I know they will deposit my check in any bank but still having it sent to US as it barely covers my medications most months, and that is at Canadian prices, which are somewhat cheaper.

    Anyone with any answers, about Medicaire, on disability./

    Hubby
  19. kbak

    kbak Member

    Hi Kelly!,
    Your my next door neighbor, almost. I'm in Newcastle WY. Where in S.D. are you? I went to Denver FFC. As you know it's very hard in this area to find anyone to help. I certainly thought it was worth going. I'll not repeat what has been said, since it's pretty well covered. I agree with whoever said they tend to be overbooked. They are. I sure hope things work out for you. Good Luck!

    K.
  20. Bailey-smom

    Bailey-smom New Member

    it is a bit long but I thought you may want to see it.

    Good luck!

    Kelly