Kidney Stone Treatment

[richard_smith237]

To avoid taking over another thread which I’d posted in I’ve started this topic: 

 

A recent medical check up found a 1cm kidney stone, 

The Dr. at Bumrungrad recommended ‘shock wave lithotripsy’ to breakup the kidney stone into what I assume will be small fractured pieces. An alpha-blocker is then taken to enlarge the upper and lower urinary tract / urethra so that the broken stones can be passed. 

The treatment is scheduled to be carried with a follow up overnight stay for observation due to risk of kidney bleed, pain management etc.

Cost is estimated at 155-170,000 baht (Bumrungrad)

My insurance cover is in patient treatment only. 

 

April insurance seem hesitant to confirm the pre-authorisation for this and has asked the hospital for more information.

The insurance company seems to be looking for wiggle room to avoid covering the treatment, especially if their argument is that this could be done as an outpatient procedure.

 

 

This is my first year with April insurance, I’ve never had a previous health insurance company deliberate over cover before. If April insurance refuses to cover this procedure I still need it carried out - but would of course look for cheaper options (and then cancel any remaining insurance cover for my Wife, Son and I and choose a company which doesn’t wiggle out of payment - LUMA have been ok before). 

 

Thus: Does anyone have any recommendations for ‘cheaper’ Shockwave Lithotripsy at another hospital (any idea of costs involved).

 

Thanks in advance. 

 

 

 

[Sheryl]

April inpatient policies pay for day hospitalizations. Not necessary to stay overnight as long as you require admission and observation for a few hours. So even if they feel overnight is not needed (and they may) that does not necessarily preclude coverage.

 

I would wait first as it is entirely possible the issue is that the hospital provided insufficient info to the insurer. Thai hospitals are notorious for this.

 

There may also be concern re whether the treatment is likely to work as it doesn't always.

 

Less expensive hospitals would include St Louis, Bangkok Christian and Thonburi Hospital.

[richard_smith237]

Thank you Sheryl. 
 

April have confirmed pre-authorisation (but have communicated extremely poorly)

[DavisH]

I was going to have this treatment on a small uterine stone at Sirirat. I was.on the table.and.they found the stone had passed. It was in my bladder, as it came out a.couple of weeks later. I.have government health cover under my wife, but I think the actual price was half of what you quoted. The only issue you would be the queue involved.for sure a 1 cm stone won't pass by itself. God help you if it does. Even my 3mm stone was very painful.

[Sheryl]

1 hour ago, richard_smith237 said:

Thank you Sheryl. 
 

April have confirmed pre-authorisation (but have communicated extremely poorly)

 

Did you communicate with them or did the hospital?

 

I had no problems myself with April but had huge problems (dragging in for weeks) with a different insurer when Bumrungrad was the hospital.  One would think they'd be good at dealing with insurers but they are not.

[richard_smith237]

17 hours ago, Sheryl said:

 

Did you communicate with them or did the hospital?

 

I had no problems myself with April but had huge problems (dragging in for weeks) with a different insurer when Bumrungrad was the hospital.  One would think they'd be good at dealing with insurers but they are not.

 

Both...  Bumrungrad communicated with April insurance directly.

I also applied via their Phone App for pre-authorisation, the phone app crashed repeatedly,  I e-mailed them directly with a scanned copy of the cost estimate.

 

 

 

The delays in pre-approval were encountered as April e-mailed the hospital forms which I needed to fill out instead of contacting me directly. 

Additionally April wanted more information from the hospital and further information from me.

 

----

 

[One would think they'd be good at dealing with insurers but they are not] - I agree. I’ve found the delays when checking out of a hospital considerably frustrating when waiting for the final bill to be approved. 

I have learned to have the Dr sign off on my (or Wife or Son’s) discharge early in the morning, then have the finance team prep the finance side of the claim so when we check out there is no delay.

It doesn’t matter how hard I try to preempt and head off any delay I still find myself waiting around somewhat unnecessarily for a few hours while the claim is sorted out. 

 

In this case April have Pre-Authorised treatment, but only to the ‘low end’ of the cost estimate and thus any cost above this ‘low end’ will require further approval and thus further delays. 

 

 

 

 

 

 

[Sheryl]

Is this April My Health Thailand or April International? I am curious as I never had to fill out any forms myself. Just the hospital.

[worgeordie]

I don't want to alarm you,as I am sure things have changed,

and I am sure the Bumrungrad Hospital is a lot better than

the Government hospital I went to 20+ years ago to have my

Kidney stone removed ultrasonically.

 

The Hospital had just gotten the machine in a few days before,

and i am sure they did not know yet how to use it properly ,

and me been twice the size of you average Thai,they were having

problems locating the stone and aiming the machine at it.

 

Anyway they started up the machine and went ahead,it was like

been hit in the back by a hammer, i could stand the pain, just,

but it was very uncomfortable and nauseous.

 

When I got home I was pissing blood,bits of which must have

been kidney, I was ill for about 3 months, hardly eating anything

I lost a lot of weight, (but unfortunately put it all back on again since) ,

I never did go back again ,I think it was supposed to be done 3 times

and the cost then was 25,000 Baht, I think I was a bit of a Guinea pig

first Farang they treated, but I have not had a problem since, except

when a few years ago I passed a small pea sized stone, not easy.

As I say things will have improved and the cost certainly risen. 

regards Worgeordie

[richard_smith237]

10 minutes ago, worgeordie said:

I don't want to alarm you

 

Gulp... I should have stopped reading at that point... 

[JAS21]

My wife has just found out that she has a few small stones ... biggest 0.6cm. She has been given Uralyt-U to take to try and dissolve them ...Dr said he will do another Ultrasound and X-Ray in three months and then decide what the way forward will be.

[richard_smith237]

4 minutes ago, JAS21 said:

My wife has just found out that she has a few small stones ... biggest 0.6cm. She has been given Uralyt-U to take to try and dissolve them ...Dr said he will do another Ultrasound and X-Ray in three months and then decide what the way forward will be.

 

Did they work out if the stones were Calcified or Uric Acid ?

[JAS21]

11 minutes ago, richard_smith237 said:

 

Did they work out if the stones were Calcified or Uric Acid ?

The guy said they were not hard stones, that is all she knows .. that powder she has is for Uric Acid stones so it says on the label. I'll post the outcome in three months...

 

I asked about 'blasting them' he said 'lets see' I didn't ask about the cost but would get it done at either Princess Chualbhorn or her registered Gov. Hospital ...same Dr at both places.

 

I actually see him myself next week, I'll ask about costs if I remember.

[richard_smith237]

1 hour ago, Sheryl said:

Is this April My Health Thailand or April International? I am curious as I never had to fill out any forms myself. Just the hospital.

 

 

April International (Underwritten by Liberty Insurance (LMG).

 

Arranged and administered by April Assistance (Thailand) Co. Ltd.

 

i.e. all communication has been with the staff at the April Insurance staff at their office in Maneeya Centre, Ploenchit Bangkok.

 

 

[richard_smith237]

7 minutes ago, JAS21 said:

The guy said they were not hard stones, that is all she knows .. that powder she has is for Uric Acid stones so it says on the label. I'll post the outcome in three months...

 

I asked about 'blasting them' he said 'lets see' I didn't ask about the cost but would get it done at either Princess Chualbhorn or her registered Gov. Hospital ...same Dr at both places.

 

I actually see him myself next week, I'll ask about costs if I remember.

 

As I understand it from some of the reading I’ve done; if the stones can be seen clearly on X-Ray they are calcified, if they can be observed with Ultrasound but cannot be seen clearly on X-Ray they are more likely to be Uric acid.

[JAS21]

2 minutes ago, richard_smith237 said:

 

As I understand it from some of the reading I’ve done; if the stones can be seen clearly on X-Ray they are calcified, if they can be observed with Ultrasound but cannot be seen clearly on X-Ray they are more likely to be Uric acid.

Only did ultra sound...I will query

[mahjongguy]

I had the lithotripsy about 25 years ago to break up a 1.4 cm stone. It wasn't terrible but it went on for 45 minutes. Thunk. Thunk. X-ray showed it was a success but later that night the bits and pieces jammed up and blocked the exit. Off to the ER, got a stent installed to keep things flowing. That worked but was in place for two weeks and was relentlessly uncomfortable. 

 

I passed a more normal size stone the following year. Nothing since. Praise be.

[richard_smith237]

1 minute ago, mahjongguy said:

I had the lithotripsy about 25 years ago to break up a 1.4 cm stone. It wasn't terrible but it went on for 45 minutes. Thunk. Thunk. X-ray showed it was a success but later that night the bits and pieces jammed up and blocked the exit. Off to the ER, got a stent installed to keep things flowing. That worked but was in place for two weeks and was relentlessly uncomfortable. 

 

I passed a more normal size stone the following year. Nothing since. Praise be.

 

    I’m going to have to stop reading this thread...  its making my eyes water...

[JAS21]

Double post removed.