timoti

On 4/2/2024 at 8:08 PM, Sheryl said:

https://www.bumrungrad.com/en/doctors/Supinda-Chusakul

 

 

It seems like that doctor is not available for quite a while so requires a visit on a different day which I might do but I saw you also recommending this doctor:

https://www.bangkokhospital.com/en/doctor/dr-songklot-aeumjaturapat

Would you recommend him over her? I will check if he is available the day I will be in BKK. If so that would be ideal of course. I just assumed Bumrungrad generally has the best doctors.

Thanks a lot I will make an appointment with her.

It's nose related like frequent bleeding (a few times a week), either randomly or when I blow my nose, with some bloody mucus.

The other issue is frequent throat clearing, not sure if that might be related to potential acid reflux, burning sensation in the throat, but this started happening before that.

Hi,

I will have to go to Bangkok and while I am there I want to show some issues I have to an ENT specialist. Can you please recommend me the best doctor for this?

Ideally Bumrungrad.

Thanks a lot in advance.

Do you guys think if the second doctor orders another colonoscopy, the insurance would have an issue with it? I will show the doctor all the documents I got which has pictures of my insides and diagnosis but there is a difference between seeing pictures vs seeing the real thing in front of you. Not sure if that will be necessary but I can't argue with the expert doctor even though the prep was very painful.

Thanks a lot everyone. I guess I will see Dr Parit then. I wonder which hospital would be better to see him. I will do telemed first. I assume Bangkok hospital would be better because the first doctor I saw is also from there so they have all my records. But I can also send it to Bumrungrad. I imagine both have telemed option. I only plan to go there if they want more tests.

I think Bumrungrad might be better though because I worry Bangkok hopsital might not want to give different diagnosis that goes against one of their own? So they might try to protect their already given diagnosis and double down on it. So I think it feels better to have these separated by hospital.

Hi,

I need to see a new gastroenterologist for second opinion and also to hopefully find proper diagnosis. I was told I had colitis and was given medicine but after 1 month, was asked to stop using it. But now I have the same symptoms back after a month of stopping the medicine. Mainly the frequent need to be on the toilet when I feel like I have some gas when I know there is also waste waiting to go out as soon as I let it out. It's not diarrhea though. But having to use the toilet 4-5 times in a span of several hours affect my daily activities.

The first doctor I saw here locally is intermediate from what I can gather by his credentials. That's why now I want to show another expert my test results and explain my symptoms. I imagine I won't have to do another colonoscopy again.

Thanks a lot in advance.

For the network thing I was told the same by AA World that you have to use the app to find the hospital and see if it's listed there, even for Thailand. If the hospital is not listed, then I believe you will pay that percentage listed. I don't remember the actual amount.

AA World gets its info from April so I think it should be correct.

25 minutes ago, JimTripper said:

What brand and specs for that price?

https://www.hidevolution.com/msi-creatorpro-x17hx-a13vm-236us-17-uhd-144hz-i9-13980hx-rtx-5000-ada.html

I will wait CES next year to see if there are better laptops coming but doubt it.

Thanks a lot. Btw I mean buying it online from Thailand, I wont go to US to get the laptop.

Hi,

I checked online it says laptops are not subject to duty but would I be charged extra by the customs beyond the 7% VAT? I never bought one from US in Thailand before but when I did in Singapore, strangely I wasnt charged tax or customs. So that made the price less than half the local price.

Before anyone says to buy it locally, the laptop is not available in Thailand, it's a custom high end laptop (~8K USD).

Would appreciate any recent experiences and gotchas.

Thanks in advance.

I recommend myprotein unflavored casein if you don't care if it's whey, otherwise they have unflavored whey too.

But in Thailand you can only find their whey unless you order international.

1 hour ago, Sheryl said:

 

All hospitalizations require pre-approval. Pre-approval process looks closely at medical necessity as well as reasonableness of cost.

 

IF  a hospitalization was approved and took place, outpatient visits directly  related to it are covered for 30 says.

 

I doubt a hospitalization would be approved just for monitoring and doing some tests as that sounds like something that could be done as an outpatient. 

 

It sounds like you are trying to arrange dubious/unnecessary hospitalizations just to get outpatient visits covered. That is not going to work.

 

Also please note my prior post about your outpatient bill submitted for direct payment. It will not be paid. 

 

 

No the second hospitalization is related to a complication the arise from inpatient procedure and april approved it. Doctor said i should stay overnight so they can see if it will be better.

I was just curious because after discharge the specialist wanted to follow up on this later on after a week.

18 hours ago, Sheryl said:

Outpatient care related to an actual (already took place)  approved hospitalization is covered for 30 days after hospital discharge. On a reimbursement basis. You pay first. Then submit medical certificate and receipt for reimbursement. 

Thanks a lot Sheryl. So a hospitalization related to a potential complication of a previous procedure, just for monitoring the patient and doing some tests would be covered on its own and it will allow future follow-ups related to this new hospitalization for a month with a different doctor in a different hospital, while being able to do follow up on the actual procedure with the original doctor?

Also if you see another doctor for potential complication related to an inpatient treatment, would April cover that within 1 month of the operation?

1 hour ago, Sheryl said:

 

I had not seen  pdf-network-specified-inpatient-providers-list-and-guide.pdf   before and will have to check with my broker. It sounds like it is a specific option people can  choose to take in exchange for a lower premium.  "You can save on your premium by choosing a Hospital and Surgery module with a Specified Inpatient Providers restriction."  I have not elected to do that, and would not.

 

You need to go by the terms listed specific to your policy which you will find posted on the online patient portal. Mine does not  refer to or link to this document. Rather it refers to a PPO network in the US. But I have emailed my broker for full clarification.

 

 

Let me know please. Because i see this in the general conditions document it's updated for 2023 they use blue text for the new changes right from the first page. There other ones i find from Google because the pdf doesn't say anything more.

I also didn't elect for this for cheaper premium so i hope it doesn't apply to us.

2022 edition didn't mention any of this.

1 hour ago, retarius said:

I'm always a bit careful with new procedures....not an early adopter. Have you been receiving treatment prior to this? If so what, amiodarone? warfarin? What has prompted the mention of surgical ablation at this time? New symptoms? 

I am familiar with the clinical data but would ask Sheryl if the data are compelling with regard to reduction in stroke risk and mortality?

No never. Doctor recommended it to me after first visit to him.

On 10/25/2023 at 8:37 AM, Sheryl said:

 

I did this before back surgery in 2019. Paid with no issue.

 

They will know it is relevant to the hospitalization from the medical certificate as this includes diagnosis. Note that a medical certificate is required for all outpatient costs claimed . Also note that the outpatient visit must have been within 30 days before or after an approved hospitalization.

Thanks Sheryl that's helpful. Also I noticed the hospital that treated me filled the insurance form the way they saw fit like they said they were first specialist that I saw about this issue. So I hope if I were to submit the real first specialist a few days prior, April won't create issues. Because hopsital's own claims dept fills these forms. Not sure if you closely inspected the same filled forms after the fact.

Also April's 2023 changes are a bit confusing, not sure if you have seen them?

"We provide you with a network of healthcare professionals who charge Reasonable and Customary costs. If You receive treatment in a medical facility that is not recommended and is nota member of the APRIL International network, You will be subject to a 20% Deductible applicable to the amount of your claim if the cost of your treatment exceeds local standards (except for vital emergencies).You will find information on the APRIL International healthcare network- in your Guide and in your Easy Claim mobile application- by contacting our team: they are available to help you with all your healthcare needs"

Finding these is a bit tricky. In the app there is no such guide. I guess you can try to submit a claim and see if the hospital is listed there?

I found this but some links are broken:

Healthcare Networks and Direct Billing | APRIL International (april-international.com)

They have this but also not sure if it's April France:

pdf-network-specified-inpatient-providers-list-and-guide.pdf (april.fr)

"In Thailand, your treatment will be subject to a 40% co-insurance for any service in Bumrungrad International Hospital, BNH Hospital, Bangkok International Hospital, MedPark Hospital, Bangkok Hospital Pattaya, Bangkok Hospital Chiang Mai, and Bangkok Hospital Samui. Members insured under a policy issued in Hong Kong or Singapore are not subject to this restriction and can choose any medical facility in Thailand subject to the clause below. You can enjoy full coverage in all private hospitals in Thailand except for the above-mentioned providers"

They also increased the copay from 20% to %50 if you fail to inform them prior to treatment. Fair enough but I hope they dont make their terms worse year after year.

I also need to do this. I am on ED visa. Do i need to transfer it from my old passport to the new one at the immigration office?

If you go to hospital A to get diagnosed and then go to hospital B to get second opinion, and decide to do the procedure there, would April pay for both outpatient visits at both hospitals if the visits are within a few days of each other? I don't know if they would consider hospital A's outpatient visit irrelevant to the procedural done at hospital B?

Not sure if anyone has done this?

I reckon it's always good to get second opinion if a better doctor is not within reach for the first diagnosis.

1 hour ago, Sheryl said:

Just glanced because not skilled in interpreting rhythms.  

 

Disregard that whole consultation. 

 

It does sound from your symptoms thst something significant is occasionally going on  but no telling at this point exactly what.  And without knowing that cannot proceed to treatment options. 

 

If for example what you are having is runs of v-tach treatment would be first medications then if not effective implantable defibrillator. 

Thanks a lot I will do that, hope it's not v-tach.

4 minutes ago, Sheryl said:

First need to find out if paroxysmal afib is what you have.  As opposed tp paroxysmal atrial tachycardia. V-tach etc. 

BPH doctor quoted my diagnosis from my ecg so i guess there is some error there already.

I also felt like he just glanced at them when i provided 30 pages of ecg. I am not sure if these things are very easy to spot or need careful looking at the graph regardless of ecg quality so it feels hasty to suggest ablation from this.

1 hour ago, Sheryl said:

 

I meant do not try to go to an inexpensive clinic to get the Holter done.  I wouldn't try it at BPH either, might waste your money. Have it done at a proper arrhythmia center.

 

If it is really a problem for you to stay in Bangkok for the duration and they recommend a longer period of monitoring, returning to Pattaya first and then coming back to Bangkok when the monitoring period is up could be an option. No problem to travel with the device on, in fact it is advantageous for it to record under a variety of types of activity.

 

Sometimes simply doing an exercise stress test is enough to provoke whatever arrythmia the patient is  having and this alone may give enough information in some cases.. That can be done on the spot. Again, need to consult expert in this area and be guided by his advise.

 

 

Thx i will do that. I lift weights every day but never had afib episode during those times only after eating some big meal. BPH doctor didn't comment on this so i hope the bkk doctor have insight on this. I heard acid reflux or gerd can also cause afibs.

4 hours ago, Sheryl said:

Me too and never heard from AA World. Even when my premium came due for renewal. Hence I changed brokers. 

AOC guy is asking for passport. Did you send this? Neither AA nor April asked for this so i don't want to send this just to change brokers.

1 minute ago, Sheryl said:

Wait and see what he recommends is my advise. As mentioned I think 48 hours for Holter may suffice.  Just plan on several days in Bangkok.

 

Do NOT try to get Holter on the cheap as the interpretation is complex and needs to be done by people specialized in cardiac electrophysiology.

 

 

Oh yes I meant going to a hospital or BPH to get a holter for recording. I won't buy one myself. You wouldn't advise that also? I just worry I wont be able to capture it in bkk in a few days but who knows. I got it for the last 2 days so we will see if it will happen tonight.

28 minutes ago, Sheryl said:

Yes

 

https://www.bumrungrad.com/en/doctors/Koonlawee-Nademanee?gclid=Cj0KCQjwm66pBhDQARIsALIR2zDdEHAXJa9pAQiDELL1rmH1gLs_M9a4wCgko4WzzalxYwoCspp5T6gaAkEkEALw_wcB

 

 

Ok they told me they charge 1.2m for the same procedure. I will have to see him first and see what he says of course.

I hope he can use the same treadmill and ultrasound results though because i paid 10k for these.

Additionally i wonder if i should go to a smaller clinic to get holter and capture an episode then bring it to him than trying to catch an episode in bkk with their holter, because i don't live there.