I need rotator cuff surgery my insurance turned me down where to go for less than 350,000b?

[Pinot]

I had a bicycle crash and screwed up my shoulder. My insurance company said it was an optional surgery and turned me down. I have two ruptured tendons and need a four-hour operation to fix this. Four screws, four days in the hospital. My arm elevated for six weeks. Vischara in Phuket quoted 350k. The surgeon is excellent. Looks like I need to pay for this myself. Are there any options? 

[NickyLouie]

Quote

My arm elevated for six weeks.

 

Brah 

[Yellowtail]

I had a rotator cuff done By Dr. Mason at Burumgrad about 10-15 year ago, but I do not imagine that would be cheaper. It is still great though. I would not skimp. 

 

I would message Sheyrl directly for a suggestion were it me. 

 

Are you working? I had my right arm in a sling for a couple months, and physical therapy three times a week. You do not have to have the PT at the same place you have the surgery, so you could have the surgery in Bangkok, and see a local physical therapist. 

[JoseThailand]

20 minutes ago, Pinot said:

I had a bicycle crash

 

Bicycle? How fast were you going?

[Yellowtail]

What insurance company do you have? I would have it done, submit a claim, and fight if it's rejected. The doctor will write you a medical certificate saying it was necessary. 

 

Unless you have bad insurance, they should pay. My insurance paid, but I never tried to get pre-approved. 

 

 

And make sure the hospital is on their approved list. 

[MadAtMatrix]

If you are that severely banged up, go see this guy. https://www.bangkokhospital.com/en/bangkok/doctor/cdr-dr-pornthep-mamanee

He is the top dog in orthopaedics, having done surgeries on many Thai olympians, pro football players, badminton players etc. 

https://en.wikipedia.org/wiki/User:TineMethavee/Pornthep_Mamanee

[Pinot]

30 minutes ago, JoseThailand said:

 

Bicycle? How fast were you going?

 

Unsecured construction fabric blew out in front of me, tossing me to the ground. Wind. It wasn't the shoulder I landed on. Tore ligaments on the other shoulder. 

[Pinot]

28 minutes ago, Yellowtail said:

What insurance company do you have? I would have it done, submit a claim, and fight if it's rejected. The doctor will write you a medical certificate saying it was necessary. 

 

Unless you have bad insurance, they should pay. My insurance paid, but I never tried to get pre-approved. 

 

 

And make sure the hospital is on their approved list. 

 

I hadn't thought of that. Have it done and resubmit it. Thanks

 

[Pinot]

10 minutes ago, MadAtMatrix said:

If you are that severely banged up, go see this guy. https://www.bangkokhospital.com/en/bangkok/doctor/cdr-dr-pornthep-mamanee

He is the top dog in orthopaedics, having done surgeries on many Thai olympians, pro football players, badminton players etc. 

https://en.wikipedia.org/wiki/User:TineMethavee/Pornthep_Mamanee

No, I have the MRI, this is straightforward now. I'm looking for a great place to save some money. I assume I'll have to pay for it. 

[Furioso]

I'd go to India they've got fine surgeons for 1/10th the cost. 

[NickyLouie]

Just now, Furioso said:

I'd go to India they've got fine surgeons for 1/10th the cost. 

 

It's filthy there 

[NoDisplayName]

8 minutes ago, NickyLouie said:

 

It's filthy there 

 

The airport is (mostly) clean.

The VIP car is clean.

The VIP section of the hospital is sparkling.

The hotel you stay in after is clean.

 

Problem might be insurance declining payment because you traveled to another country for treatment.

 

If you must pay yourself, India is a bargain even with airfare.

 

Rotator Cuff Surgery Cost in India - Get Cost Estimate. Minimum Cost 5500 USD. Average Cost 6000 USD

[richard_smith237]

2 hours ago, Yellowtail said:

What insurance company do you have? I would have it done, submit a claim, and fight if it's rejected. The doctor will write you a medical certificate saying it was necessary. 

 

Unless you have bad insurance, they should pay. My insurance paid, but I never tried to get pre-approved. 

 

 

And make sure the hospital is on their approved list. 

 

It doesn't work like that...   The insurance has to pre-approve... 

 

Or.. If you have it done pay yourself, then make the claim and they reject, Op is out 350,000 baht...  even if he fights....   he could get the surgery for much less in India, so its a good option.

 

 

That said: The Op should first get another 'more insistent letter' from is Surgeon / Doctor and re-submit the pre-authorisation claim.... unless there is a pre-existing condition the Op has not mentioned.

[richard_smith237]

2 hours ago, MadAtMatrix said:

If you are that severely banged up, go see this guy. https://www.bangkokhospital.com/en/bangkok/doctor/cdr-dr-pornthep-mamanee

He is the top dog in orthopaedics, having done surgeries on many Thai olympians, pro football players, badminton players etc. 

https://en.wikipedia.org/wiki/User:TineMethavee/Pornthep_Mamanee

 

How's that money tree of yours looking ???

 

A good surgeon is great advice - but the Op's insurance has refused to pre-authorise his claim, so going to a more expensive hospital is not going to help him at the moment.

[richard_smith237]

2 hours ago, Yellowtail said:

What insurance company do you have?

 

Valid question - that would be good info for many shopping around for insurance.

[scubascuba3]

I have a labral tear, when the surgeons said it's a 50/50 op, all that downtime and may not work, decided not to bother, and that would have been paid by insurance 

[Yellowtail]

7 hours ago, richard_smith237 said:

 

It doesn't work like that...   The insurance has to pre-approve... 

 

Or.. If you have it done pay yourself, then make the claim and they reject, Op is out 350,000 baht...  even if he fights....   he could get the surgery for much less in India, so its a good option.

 

 

That said: The Op should first get another 'more insistent letter' from is Surgeon / Doctor and re-submit the pre-authorisation claim.... unless there is a pre-existing condition the Op has not mentioned.

My family was insured here for over twenty years. First by Heath Net, then by Cigna and finally by Blue Cross Blue Shield. I never got anything pre-approved. I paid for the service, and filed the claim, and I got reimbursed. 

 

A few times claims were denied, I contested the denial, and every claim was ultimately approved. Supplements were not covered, but they would sometimes be approved anyway. 

 

They used to nitpick my annual physical and say some of the things were not covered, and only partially reimburse. Resubmit explaining it was a package, and it was approved. 

 

I had twenty years of medical, including a rotator cuff and two knee replacements. 

 

 

 

If you don't ask, the answer is no. 

[MadAtMatrix]

8 hours ago, richard_smith237 said:

 

How's that money tree of yours looking ???

 

A good surgeon is great advice - but the Op's insurance has refused to pre-authorise his claim, so going to a more expensive hospital is not going to help him at the moment.

You get what you pay for. Too many people wanting “cheap” done. Then they end up having to have it fixed again a year or two later because they cheaped out. I’m in the same situation (not because I was cheap, I paid about 300k at a reputable hospital chain that has Bangkok in its name, but because the surgeon screwed up) and now I need it fixed again. 
 

if you want cheap, like mentioned above, go to India or go to Vietnam

[scubascuba3]

3 hours ago, MadAtMatrix said:

You get what you pay for. Too many people wanting “cheap” done. Then they end up having to have it fixed again a year or two later because they cheaped out. I’m in the same situation (not because I was cheap, I paid about 300k at a reputable hospital chain that has Bangkok in its name, but because the surgeon screwed up) and now I need it fixed again. 
 

if you want cheap, like mentioned above, go to India or go to Vietnam

Does paying more guarantee success? 

[Yellowtail]

11 minutes ago, scubascuba3 said:

Does paying more guarantee success? 

Exactly, it comes down to how good the doctor is, how well equipes the facility is, and a bit of luck. 

 

The liver doctor I was seeing at Bangkok Hospital also worked and taught at Chula. He quit Bangkok Hospital and so I stated seeing him there. The bills went from about 1,500 to 100 to see the same doctor. 

 

The Dentist I see at BHBC also teaches and practices at Chula, but I still see her at BHDC.  

 

[MadAtMatrix]

1 hour ago, scubascuba3 said:

Does paying more guarantee success? 

I don’t know. It would be up to your own experience.

 

 

What I do know is that the guy I posted earlier is the head of Sports Medicine  at Bangkok Hospital and has conducted thousands of knee and shoulder surgeries. I have met an orthopaedic surgeon that worked at Siriraj with Dr Mamanee years ago and he told me that he is the best of the best. I have consulted with him three times and he has told me to hold off from repairing the shoulder for three years now, however the arthritis has become to the point that surgery needs to be done and to clean up the mess left behind by the first guy. 
 

 

[richard_smith237]

4 hours ago, MadAtMatrix said:

12 hours ago, richard_smith237 said:

 

How's that money tree of yours looking ???

 

A good surgeon is great advice - but the Op's insurance has refused to pre-authorise his claim, so going to a more expensive hospital is not going to help him at the moment.

You get what you pay for. Too many people wanting “cheap” done. Then they end up having to have it fixed again a year or two later because they cheaped out.

 

To be honest, your comment comes across as rather prejudiced. These so-called "cheap" Indian doctors you're disparaging are, in fact, the very professionals who have played a vital role in supporting the UK’s National Health Service. I've worked alongside many highly educated Indian doctors and have no hesitation in trusting their ability to carry out procedures like this one - which, I might add, is considered fairly *routine nowadays.

 

One could just as easily expect to see dismissive remarks from some posters about Thai doctors and surgeons, with the suggestion being to seek treatment in the US or our home countries, where it's often assumed the highest medical expertise resides. Yet we haven't, and for good reason. The truth is, Thai medical professionals, by and large, are highly competent and frequently outstanding, as are Indian Doctors.

 

*Of course, I refer to such surgery the op requires as “routine” because such surgeries are generally straightforward. However, if your condition happens to be atypical or presents complications, then yes, I would absolutely recommend seeking medical advice back home where costs could escalate significantly.

 

4 hours ago, MadAtMatrix said:

 

I’m in the same situation (not because I was cheap, I paid about 300k at a reputable hospital chain that has Bangkok in its name, but because the surgeon screwed up) and now I need it fixed again. 
 

if you want cheap, like mentioned above, go to India or go to Vietnam

 

I'm in a similar position myself, having undergone surgery last year at a leading hospital in Bangkok. I’m still experiencing issues with the same joint, but I wouldn’t rush to claim the surgeon made a mistake - unless you have proof you are unqualified to make such a claim...  Also, we (all patients) need to understand that not every operation leads to a perfect result - surgery isn’t always a guaranteed fix, and recovery doesn’t always follow a neat, predictable path.

[Yellowtail]

With the rotator cuff, using the sling and doing all the PT is critical. 

 

If you pick your arm up on your own, you can damage it. 

[richard_smith237]

1 hour ago, Yellowtail said:

1 hour ago, scubascuba3 said:

Does paying more guarantee success? 

Exactly, it comes down to how good the doctor is, how well equipes the facility is, and a bit of luck. 

 

The liver doctor I was seeing at Bangkok Hospital also worked and taught at Chula. He quit Bangkok Hospital and so I stated seeing him there. The bills went from about 1,500 to 100 to see the same doctor. 

 

The Dentist I see at BHBC also teaches and practices at Chula, but I still see her at BHDC.  

 

A great deal of a surgery’s success ultimately comes down to us – to our own efforts and how committed we are to proper rehabilitation.

 

After a major incident last year, I took post-surgery rehab extremely seriously. I wasn’t at all satisfied with the hospital’s half-hearted and, frankly, rather underwhelming approach to physiotherapy. I raised my concerns, dismissed their rehab team, and - under the guidance of my orthopaedic surgeon - undertook my own tailored rehab programme. The results were excellent, and I have no regrets.

 

However, with a subsequent injury that also required surgical intervention, I’ve been far more relaxed in my approach. I didn’t prioritise rehab in the same way, and I returned to active sports far too soon. Unsurprisingly, I’m now paying the price and may require further treatment.

 

The point is this: when it comes to recovery, we often underestimate the importance of our own role. Stretching, strengthening, and diligently working the muscles and ligaments are just as critical as the surgery itself.

 

So when I hear people say “the surgeon screwed up,” I can’t help but wonder how seriously they took their own rehab. No accusations here - just a perspective I think deserves some honest reflection.

[NoDisplayName]

5 hours ago, MadAtMatrix said:

f you want cheap, like mentioned above, go to India or go to Vietnam

 

I have no complaints with the Indian surgeon who replaced my aortic valve.

 

Cheap at 1/3 less than Thai cost at the time, 1/10th the cost of surgery in the US.

 

Six weeks after surgery  I was able to bicycle a century, six months later bicycled from Kunming to Chiang Mai.  Less than a year after surgery completed the Chiang Mai marathon.

 

[Yellowtail]

One problem with going to India for rotator cuff, is the long recovery. It takes months, and you go back every other day, then every week. Flying in a sling, and risking bumping your shoulder would be a nightmare. 

[scubascuba3]

7 minutes ago, NoDisplayName said:

 

I have no complaints with the Indian surgeon who replaced my aortic valve.

 

Cheap at 1/3 less than Thai cost at the time, 1/10th the cost of surgery in the US.

 

Six weeks after surgery  I was able to bicycle a century, six months later bicycled from Kunming to Chiang Mai.  Less than a year after surgery completed the Chiang Mai marathon.

 

But how did you vet the good from the bad to make a decision? 

[sometimewoodworker]

16 hours ago, Furioso said:

I'd go to India they've got fine surgeons for 1/10th the cost. 

For an umbilical hernia India was roughly the same cost as a local Bangkok hospital without travel. However the main northeastern teaching hospital’s private wing was half the cost with the operation performed by the top consultant surgeon. The main difference was in nightly room costs with the the amounts being 26,000 per night vs 3,500

[Nicco]

Try St Louis hospital. If nothing else private room is like 3-5k night. Perfectly acceptable. Many of the specialists work at the top university hospitals as well as private hospital s

[madone]

6 hours ago, MadAtMatrix said:

You get what you pay for. Too many people wanting “cheap” done. Then they end up having to have it fixed again a year or two later because they cheaped out. I’m in the same situation (not because I was cheap, I paid about 300k at a reputable hospital chain that has Bangkok in its name, but because the surgeon screwed up) and now I need it fixed again. 
 

if you want cheap, like mentioned above, go to India or go to Vietnam

 Rather contradictory remarks -- you get what you pay for, I paid lots, now I need to fix it doesn't make much sense