Hi everyone,
After corresponding with @Moltroub, I thought the list below might be helpful for some folks. Please feel free to add to it, or to disagree if you find something erroneous.
- Choose a neurosurgeon/neuroradiologist you are comfortable with. Do homework on him/her. Where did they go to medical school? Where did they do their training? How many years of experience do they have? At what hospital(s) do they perform surgeries/procedures at? Do you like the hospital they go to?
- Call the number for customer service on the back of your insurance card or go to the website to make sure your surgeon, neuroanesthesiologist, AND hospital are in-network. Do not assume anyone will tell you this. If you are ok with going out-of-network for your care, find out how much you will need to pay. You may be in a situation where Barrow Brain and Spine is in-network as a practice, but Michael Lawton is not, as an example.
- During your appointment ask your NS/NR how many of the specific procedures they have performed on your aneurysm type, location, and with the technique used. As an example, Dr. Bendok has done hundreds of FDS procedures and started using them at their inception in 2013. When I asked him how many FRED FDS he has done, he stated he was in the clinical trials (we didn’t ask further questions). I wish I would have asked if he has ever treated a clipped blister aneurysm residual with FDS, but I forgot and that bothers me.
- They are going to order tests. Lots of tests. Make sure those tests are covered by your insurance. As an example, the Verify Now test that measures platelet function is not covered by most insurance companies. It was ordered for me regardless. My dad goes to Mayo, and none of his diagnostic tests are covered. He pays out of pocket. There is nothing worse than surprise bills.
- Make sure that before your surgery your NS/NR complete all necessary prior authorizations and letters of medical necessity. Insurance companies can and do decline coverage. Then you get stuck with the bill. Again.
- Now that you are feeling pretty good about things, you should start to be your own patient advocate. Do not assume the rest of your care team is up to snuff. The ever important neuroanesthesiologist may actually be a CRNA or nurse anesthetist. Please, I implore you, to ask this ahead of time. Especially the craniotomy folks. A CRNA has not gone to medical school. They did not do a residency in anesthesia or a fellowship in neuroanesthesia. I found out during my pre op appointment that Mayo uses CRNA and that the NS covers 2-3 rooms. This really knocked me back and after speaking with my NS, we cancelled my case. No one was comfortable at this point. After a call with the head of neuroanesthesia, we found out the why behind this, and as you can guess, it’s called $$$. He told us he would love to do his own cases but isn’t allowed to. Seriously? After all of that training you can’t run your own cases. He did promise us he would be over seeing my room, do all of the hard stuff (art line, intubation, extubation etc) and that he would hand select the CRNA. We received a text with the name and cell number of the guy that will be working with the NA, so now I am starting to feel a bit better about things. My craniotomy was done at Barrow in 2016 and I did have an NA and her chief resident. I never felt uncomfortable with that team. I knew I was in good hands.
- My case has been rescheduled for 4/26 and I feel better going in, but I do wish I could have the NA all to myself…