Wait times and cost?

[Hankgv]

Just curious- can anyone give me an idea about how much it costs to see a neurologist in the States, and what the wait times are? I'm in Canada and the wait times are just ridiculous. I am considering paying cash and crossing the border.  I had M.S. symptoms since July 2010, and have only been seen twice since then by a general practitioner.  In December I requested to see a neurologist to rule out M.S. and the doctor agreed.  But it wasn't until just last week that I finally got an appointment date with him, and the appointment is not going to be until the end of May.  Anyone know how much it's going to cost in the U.S. and if I'll have to wait till May anyway? Worth it or not?

[doublevision1]

I am also Canadian and have some experience with medical consultation in the U.S.  I self-referred to the MS Clinic and Brigham and Women's Hospital in Boston in 2008 after I had been dx'ed in with MS to seek a 2nd opinion on treatment.  The cost of a consult with one of their newer neurologists was $550 which was 20% less than what they bill insurers as I paid out of pocket.  It was an hour or so consult in which he took a detailed history, did a neurological exam, viewed my numerous MRIs I brought with me, and gave me his opinion on my treatment plan.  He had read all of my reports that I had emailed ahead of time.  I felt it was worth the money as it reassured me that my gut instinct in trying Copaxone before going to a more aggressive drug was the best approach, and so far this seems to have been the right call.  In terms of timing, I called them in May, got an appt for Aug at a time when I was to be in Boston.  It seemed like they were being very accommodating due to my schedule, I got the sense the wait is usually longer for first time patients.  The cost for MRI was in the several thousands of dollars which thankfully I didn't need, as at that point I'd had had numerous MRIs at zero cost to me.

What others have said about timing in the U.S. is much the same as here in Canada; some locations have longer wait lists than others, and several factors can affect these wait times.  The fact that you requested a referral in Dec and it took 2 months for you to get an appt date 3 more months down the road leads me to think that your request fell through the cracks for a while.  I say this because for specialist referrals I've sought, I was informed within a week or two of my appt date usually within weeks of the referral.  Sometimes this was because I got a call back, but more often it's because I took the initiative to call myself to make sure I didn't fall through the cracks.  Same with appts for tests incl, MRIs.  More than once I just happened to call when someone else had just canceled, and I was slotted in the very same day.  The one time I did wait patiently - for months - for my very first neuro appt, it turned out someone made a mistake and my referral was never received by that neuro.  I learned then never to leave it in the hands of the system and take charge myself.

I'd encourage you to call that neuro's office directly, politely ask if anything has opened up prior to your appt in May, and if not ask to be put on a short notice list, and also ask if they mind if you check in from time to time to see if anything has opened up.  Chances are good you might get seen sooner, especially if you are polite and friendly with the receptionist.  In the meantime if your situation is more pressing (ie missing lots of time from work due to your symptoms; in a greatt deal of pain, etc) it is wise to look at other options such as those south of the border, but I'd focus at least as much effort trying to influence a quicker appt on home soil,  I didn't think the $550 was outrageous but costs will add up with travel accommodation, etc. and if your symptoms continue - whether caused by MS or somehting else - you will need follow up care close to where you live and covered by your provincial health care plan.  

Also if your symptoms worsen dramatically while you wait, be sure to keep your GP apprised, as this may also serve to expedite your referral.  If things get really bad and you need to go to an ER, this will often expedite matters as well, particularly if you present with symptoms that can be objectively measured.  It was when my symptoms worsened from *just* fatigue and numbness to severe double vision that really got the ball rolling, they tend to react quickly to dramatic changes in vision in order to rule out scary things like brain tumours.  I had another MRI within days and very soon after seen by an on-call neuro who referred me to the MS clinic at U of A, where I have gotten great care.  

Good luck to you and let us know how things turn out.

[COBOB]

Just got a bill today for a medium complexity office visit at CU HSC for an established patient was $177.00 (not including the facilities charge.)  That is before the insurance write off.

Bob

[jujuminx]

I am in Dallas area and wait times are a matter of maybe 2 weeks. Cost-wise I have no idea since my insurance picked up all of it but most hospitals/doctors will give you a huge cost break if they know you are paying out of pocket.

Good luck!

Julie

[allmymarbles]

Yes, New York is fast. I never have trouble getting an appointment with a specialist. I don't know about a wait for MS because I don't have it.

[HVAC]

Our wait times in our area of North Carolina are 6 to 8 months with a Doctor's referral. I am in with a MS Specialist at Duke and I got bumped from my six month appointment he is so busy, so I might see him once in 2011. With insurance I pay $200 on top of $600 a month premium. There is a shortage of MS Specialists in most places in the US as well. Sometimes you get lucky and live in the right place or get the right appointment. Also with the US medical system it is hard to get a price ahead of time since the billing is so strange with everyone on different insurances.

A place like New York City might be good. Many of the folks I know here in NC go to New York for care.

Alex

[allmymarbles]

I don't know what it would cost, but a private patient without insurance probably doesn't have to wait long at all.

[addicted2harleys]

I think that it is kinda hard to answer this question accurately for you.  I think it would depend on what state you are plannig to cross over to.  I think the prices will vary state to state, as will wait times.  This is just my opinion though.

Your best bet would be to google for neurologists in whatever state you are considering.  Or MS neurologists.  Then call a couple of them and ask how much it would cost and their wait time.  

This is what I do here in the states.  I don't have a neurologist to see that is close to me.  So I had to consider some either north or south of me.  I called both.  Then made a decision.  

Hope this helps.  Good luck!
Addi

[COBOB]

My wait was about two weeks at a major teaching hospital (in Colorado) and the charges were about $300.00 for the exam and facilities charges before the insurance write down and their 80%.

Bob