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I went through this. Needed to see a vascular specialist at Stanford while I was still stuck with Kaiser's HMO. $1000 for ~15 minutes.


Personally, we’ve been happy with Kaiser, so I’ll ask for more details.

Was it that Kaiser wouldn’t refer you? Or did you want a second opinion?


I had an ipsilateral recurrent DVT in my left leg. Kaiser failed on so many levels: at the ER I should've been treated with some kind of thrombolysis or mechanical thrombectomy, but was only offered Lovenox and Pradaxa. The internal medicine physician I had failed to refer me to a specialist for follow up, and without care and investigation, I developed post thrombotic syndrome in that leg, which means I spend the rest of my life in some degree of pain with the possibility of developing ulcers.

The specialist I went to see at Stanford, Lawrence Hofmann, was very clear that had I presented within the first two weeks, he could have simply removed the clot, but since I saw him 5 months after the event, the thrombus was chronic and wouldn't respond to treatment.

In the end, I had to leave the USA and get a proper diagnosis by surgeons in Italy: turns out I had a congenital compression of my left iliac vein which was causing the clotting and a stent was placed to open the vein.


Does anyone know how much of that $1000 goes to the specialist?


About your co-pay


Where does the rest go?


To the so many MBAs , admins, lenders, shareholders, clerks, hospital CEOs, janitors, nurses, et al who need to be paid.


I think about 30% is consumed simply by billing.


I pay $30 for specialist referrals within Kaiser network under HMO plan. Why would you go out of Kaiser network for specialist referral by your GP?


Maybe it's a well known specialist?




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