Recommendations in SF Bay area for TKR surgeons

fetalsono · #1 February 7th, 2010, 05:45 AM

I live in Marin county, Bay Area and work in San Francisco. I am going to need a knee replacement in the next 6-12 months. I have been given a recommendation for Dr. Ries at UCSF. Any other or thoughts?

Thanks

**Josephine** · #2 February 7th, 2010, 10:34 AM

Who recommended him? Have you checked out any others? You can find some other using the Clinic/Surgeon Locator on the main BoneSmart page.

MerryS · #3 February 9th, 2010, 09:27 PM

I am in the health care field and am very fussy about medical providers. I interviewed 5 of them in the Bay Area until I found one that I really like. Scheduled for a BTKR on May 10th. Found James Hartford in Palo Alto. First words out of his mouth were: the most important thing that we need to address is pain control. I fell in love!!
Wonderful staff.
Works out of Sequoia in RWC and Stanford Hospital. I chose the former. Now looking at rehab facilities. Happy to share.

Merry

**Josephine** · #4 February 10th, 2010, 06:00 AM

Hello, Merry - what a lovely name! Welcome to BoneSmart. What do you do in health care? I love what your surgeon said! Spot on!

MerryS · #5 February 12th, 2010, 03:13 PM

Hi All. I thought I would post some information that may help you.

I am a health care reimbursement specialist. Nearly 70 and very young. Scheduled for BTKR and have done so much research so thought I would share.

Rehab: I started looking. The first one I went to had no one under 300 years old. There was just no joy in the place. It was quiet, semi private rooms but I did not see staff smiling. Red flag for me: How was the staff treated and how happy were they with their jobs which would affect me as a patient.
The second one was an acute rehab with low toilets. Really!! There were metal bars on the walls for support but when I asked about this, the response was: Well, you will use a bedside commode for the two weeks that you would be here. I howled and responded. I will be in rehab so that I can set goals for my recovery. Why would anyone think that I would be doing this for two weeks. She even invited me to bring an extended seat with me. Yikes.

Ok, hold your breath because the third visit was the absolute best and it is available in many parts of the country. It is part of the Hyatt Chain..(no joke) It is called Hyatt Classic and they have a wonderful facility. All private rooms, dining rooms with table cloths and fresh flowers, wireless connections in the rooms..and the atmosphere is of community and family. They have entertainment at night, cocktail hours, a beauty shop etc.
So you think that you cannot afford this, right? Medicare pays for this..and if you have Medigap, you will have no cost except perhaps a beauty salon or a massage etc.

My specialty in the health care field is Medicare so I am telling you the accurate information. Happy to answer questions related to Medicare or anything insurance related.

Here is some more info:

PT: Medicare has alwaya extended the cap for PT and OT each year. What that means is that if you have circumstances that you need more of these services than are allowed, you can get them with physician documentation. (this is for out patient PT) In 2010 they did not extend this so every patient on Medicare is restricted to $1860 total for the year for PT and another $1860 for OT. So if you have a knee replacement, Medicare will only pay up to that figure and under no circumstances will they pay for anything else. Those of us are on Medicare will have to pay out of pocket for the services EXCEPT..and this is the trick..
If you go to a facility that is part of a hospital, you can go to PT and OT and have unlimited services again with proper documentation.

Why the difference you ask? Medicare for outpatient services for PT and OT is billed to Part B Medicare. (the same as your provider bills). If the facility is part of a hospital, you are still an outpatient but they bill to Part A which is hospital billing.

So, be sure that you go to a hospital based facility for your PT so that you will not be forced to perhaps stop this very important therapy.

###This only applies to Original Medicare and not to a Part C plan or Advantage Plan.

I hope that this information helps you all.

Merry

**Jamie** · #6 February 12th, 2010, 08:55 PM

Wow, Merry.....EXCELLENT information!!!! This is so important for US patients, I'm going to move it to it's own thread and put it in the library!!! I believe you have helped a LOT of people with this post.

I never knew about the Hyatt facilities and I'll do a little checking into that one. Thanks again!!!

**Josephine** · #7 February 13th, 2010, 02:09 AM

Sounds almost too good to be true!

Good move, Jamie

**Jamie** · #8 February 13th, 2010, 09:13 AM

You know, as Merry so beautifully illustrated, our American health care system has many complex facets. The more you investigate and research, the more you can find ways to do things better and less expensively. It's one of the things I like about it....it keeps us on our toes and always searching for the BEST way to get something done....keeps us thinking. I think I must be a bit twisted maybe....

MerryS · #9 February 13th, 2010, 12:31 PM

Had to share this: One of my adult daughters thought I was using the Hyatt just as an example of a "better place to be" Told her I would have used the Ritz Carleton if I had been playing with names. Seriously, it is the Hyatt. <g>

**Jamie** · #10 February 13th, 2010, 01:41 PM

Quote:

Originally Posted by MerryS

Ok, hold your breath because the third visit was the absolute best and it is available in many parts of the country. It is part of the Hyatt Chain..(no joke) It is called Hyatt Classic and they have a wonderful facility. All private rooms, dining rooms with table cloths and fresh flowers, wireless connections in the rooms..and the atmosphere is of community and family. They have entertainment at night, cocktail hours, a beauty shop etc.
So you think that you cannot afford this, right? Medicare pays for this..and if you have Medigap, you will have no cost except perhaps a beauty salon or a massage etc.

Merry, when I Googled Hyatt Classic, all the web sites I saw indicated the facilities were retirement residences, not rehab facilities. Do you have some type of link that shows rehab services available?

MerryS · #11 February 14th, 2010, 02:32 PM

Jamie..I will check on Tuesday with the contact that I have at the Hyatt where I will be going and send you some more information. They are called Care centers I think, There went into the sign that said Care and not the SNF. I promise to report back to you.

MerryS · #12 February 14th, 2010, 02:42 PM

Although the Hyatt classic model is for long term residents, there are several phases of this care. They can live independently, live in an assisted community and also in a SNF all part of the "package". Because there are beds available, they open these beds up to outpatients. Some of these facilities may be totally booked..I think you have to contact the individual facilities. I will check into this more.

Merry

**Jamie** · #13 February 14th, 2010, 10:02 PM

Thanks, Merry. It did sound like a good option for some people and I want to be sure we present it correctly. A link to a web site for more information would be the best way to go.

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The Following 3 Users Say Thank You to MerryS For This Useful Post:
1jt@atime (February 12th, 2010), Jamie (February 12th, 2010), Josephine (February 13th, 2010)

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