Surgeon won’t accept self paying patient

barrier86

Possibly the wrong area of boards to post this, but here it goes.

I need surgery on my shoulder as a result of a RTA last September. I got my MRI, went to the specialist and he said keyhole surgery was required. I called my insurance company and low and behold, I’m not covered under my plan. I priced the surgery and have the funds available for it, called up my shoulder surgeon only to find he doesn’t allow self pay, insurance companies only! Has anyone else encountered this? Is it normal practice??

Mrs OBumble

barrier86 wrote: »

Possibly the wrong area of boards to post this, but here it goes.

I need surgery on my shoulder as a result of a RTA last September. I got my MRI, went to the specialist and he said keyhole surgery was required. I called my insurance company and low and behold, I’m not covered under my plan. I priced the surgery and have the funds available for it, called up my shoulder surgeon only to find he doesn’t allow self pay, insurance companies only! Has anyone else encountered this? Is it normal practice??

He may be concerned re who pays if their are complications.

He should be referring you to someone else, if he doesn't want to treat you. Sadly that may be the HSE, who may assess you as not needing the surgery, or put you on a long waiting list.

barrier86

Mrs OBumble wrote: »

He may be concerned re who pays if their are complications.

He should be referring you to someone else, if he doesn't want to treat you. Sadly that may be the HSE, who may assess you as not needing the surgery, or put you on a long waiting list.

Cheers. Bit of a downer to be honest - I suppose that’s just the nature of the beast

JustJoe7240

Would this not be a case for the motor insurance of those at fault of the RTA?

barrier86

JustJoe7240 wrote: »

Would this not be a case for the motor insurance of those at fault of the RTA?

I am not really sure to be honest. The insurance company are trying to offer me money to walk away from the claim, I am not prepared to do that as I am having major issues with my shoulder and it requires surgery. I want to wait to see how I progress post surgery before going to PIAB etc...

I’m going to call around a few more surgeons to see if they can do anything. My shoulder is popping out of place on a constant basis and I’m left with a dead arm for a few days after it happens. Simply can’t go on like this

frozenfrozen

I could pm you the name of a surgeon who did work on my shoulder after an rta?

gibgodsman

Its 100% down to the cause of the RTA's insurance to pay for it, not your insurance company

barrier86

frozenfrozen wrote: »

I could pm you the name of a surgeon who did work on my shoulder after an rta?

If you could, that would be great!

barrier86

gibgodsman wrote: »

Its 100% down to the cause of the RTA's insurance to pay for it, not your insurance company

I understand that, however the surgeon only accepts health insurance patients, while I do have health insurance I don’t have the the correct coverage for this. I offered to pay, knowing I’ll be reimbursed, but they refused me as a self paying patient.

Eggs For Dinner

gibgodsman wrote: »

Its 100% down to the cause of the RTA's insurance to pay for it, not your insurance company

The insurer will meet their obligations, but it will be a cash payment and that's the issue for the OP