u/Internal_Ad1642

Hi all :)

I've spent way too much time on this subreddit with all my anxious questions and fears, with the latest one being my inability to do a leg raise and just wanted to outwardly state that this takes time and I'm done overthinking it (for now ....)

It's hard not to compare my timeline with the "average" or other experiences I've seen here but I think there's a point where you need to step outside your head and realize these things take time, and as long as I remain diligent about doing my PT/icing/elevating, then it'll be alright.

Hope anyone else that's struggling is able to give themselves some grace and remember their recovery is unique to them, and things will eventually fall into place :)

On a separate note I cannot wait for this damn NWB period to end <3

Hi all,

First time poster here and really hoping for some input since I feel like I'm nearing the point of insanity.

I'm scheduled for an ACL reconstruction surgery (and meniscus repair) in NYC which got pre-authorized by my insurance. I'm anticipating three separate bills for this procedure: surgeon, anesthesiologist, and the facility.

Given this is an arthroscopic procedure, my insurance plan has a limit on the dollar amount they'll cover for procedures performed at an in-network hospital ($6000). There's no limit on what they'd cover for procedures performed outside a hospital setting: ambulatory surgical centers.

Although I'll be going to an in-network hospital, I've been told by my surgeon's office that the setting IS ambulatory, and they've seen miscommunication in the past where insurance assumes it to be billed under the hospital and states it wouldn't be entirely covered in that case, yet when the facility bill comes in, it tends to be fully covered. I'm not sure how to take this, as my surgeon's office isn't who would be sending the facility bill. Assuming it should be taken with a grain of salt?

I'm pretty conflicted on how to proceed at this point, anyone I speak to from my own insurance seems to be limited on what they see from their end, since it IS a hospital and I think that's enough for them to enforce the $6000 cap coverage. On the other hand, I don't know if it's possible for the facility bill to come in and reflect that it was an ambulatory setting, and if that'd be sufficient for my insurance to fully cover it in that case?

Really appreciate any input and best course of action I can take at this point to ensure no surprises with the bill!! Thank you