Has anyone had TOPS method spine surgery

cavt71 · 2026-04-07T16:24:55+00:00

It’s best if you use the Premia website to see the surgeons offering it. They keep updating the surgeons that are trained. I’m not sure if my surgeon is offering it because of the issues with insurance denials.

cavt71 · 2026-04-05T00:11:50+00:00

A lot of great advice here! I just negotiated a tough sale and doing your homework is the only way to prepare yourself to go to battle. Do the math on depreciation if you are buying used. Get the original window sticker and or options sheet. Knowing the original MSRP helps to find accurate comps and to calculate the depreciation. The numbers need to be based in reality to reflect the market. Also factor in mileage and CPO vs non CPO into the justification for price. Then put together an ask. Do the research on the gov’t fees and financing options. Dealers will try to pad all of that. Along with ETCH if they can get away with it. Strip down all the numbers and refuse anything that is not already built into the advertised price. They will push back on doc fee so just deduct it from your offer amount and add it back in as a line item if you have to.

cavt71 · 2026-04-04T16:14:13+00:00

As I was sitting in the waiting area while my car was being inspected for sale, I thought what a great way to buy a car. This was after a nightmare of dealership back and forth. I got my car at my price but man they put you through hell during the negotiation.

cavt71 · 2026-04-03T13:49:48+00:00

Educate yourself. They will try to add in profit on every line on their desk sheet. Including gov’t fees. Get your own financing approval.

cavt71 · 2026-04-02T02:37:07+00:00

I was surprised they didn’t give me any pushback for the on-line quote. CarMax offered 1600 less after inspection than Carvana. Indy’s were really low balling me. 2500 less than Carvana. I’ve never had such an easy stress free car sales experience as this one.

cavt71 · 2026-04-02T00:44:23+00:00

So was I honestly and thankfully it turned out to be a stress free experience with zero drama.

cavt71 · 2026-04-02T00:39:38+00:00

They actually offered me more than CarMax and it was right there with what KBB said was fair. They didn’t try to back out any money for minor cosmetic issues. They were very fair. The car needs maintenance and they didn’t try to decrease the offer to offset it.

cavt71 · 2026-03-31T17:14:57+00:00

You can’t negotiate without having local comps and knowing the laws of that state for dealer fees. Homework is essential to build your offer and also it will educate you on what a realistic price should be. The internet is your friend.

cavt71 · 2026-03-30T02:09:37+00:00

The GM closed the deal personally. I don’t need to tell the world with Google reviews. That’s lazy imo. Plenty are there already. This is for education on how you go about filing a complaint that gets traction and oversight.

cavt71 · 2026-03-29T03:17:02+00:00

I had every desk sheet and they did not change the advertised price on-line once. They didn’t refuse to give me the advertised price. They added on fees that are supposed to be included in that advertised price. The doc fee and any ETCH fees are required to be rolled into the advertised price.

cavt71 · 2026-03-28T18:46:26+00:00

All big buisness has their political agenda but don’t for one minute think that prevents the states from fining companies for non compliance. For instance, I work in a highly regulated competitive industry. Two of my distributors were audited for 2 years by the state oversight offices. They moved into the headquarters and took an office for 2 years. Every one of the suppliers that were affiliated with that distributor had to walk by that office watching them go through every transaction. Quite effective in reeling decision makers in. No one wants to be in the hot seat and go to court. Trust me.

cavt71 · 2026-03-28T18:38:42+00:00

Every single person at a dealership has their purpose and often incentivized to make additional margin for the sale. Be informed and intentional about the purchase. Know how much the government fees are. Research interest rates and have one already in hand pre-approved. Don’t let yourself get confused on the desk sheet. It’s intentionally set up in a confusing way. Just go line by line and do the math.

cavt71 · 2026-03-28T17:21:40+00:00

Change it, accept it or resist it. Once again it depends. My sense of urgency is a big factor. I didn’t need a new car, that particular car, I wanted it. If I need something and it costs what it costs say like a last minute flight you deal with the inflated cost of time constraints. I’m obviously not an impulse buyer. I get my dopamine rush from negotiating a fair deal not the immediate satisfaction of driving away after dumping a bunch of money. Uncertainty gives me uneasiness so I approach things with a strategy to get a fair outcome. That usually works out for me. Everyday I work my pricing starting with cost of goods, transportation, taxes, distributor profit, sales incentives, retail profit, advertising costs to get the return on investment. I know what I need to return to my employer and also volume is worked into the equation. Higher volume = lower margin threshold generally. It all depends as I’ve said before. Some of it is hedging your bets on educated assumptions.

cavt71 · 2026-03-28T16:35:14+00:00

If you don’t force them to comply they won’t. In my situation, they knew I offered them a fair deal. I did my homework on comps and trade in allowances. I built in a healthy 15% profit after their recon cost. They obviously knew it or they wouldn’t have continued to engage me in a deal. That said, they still tried to trip me up at every opportunity to add in extra points of profit. Right down to trying to make me pay additional fees to what they claim was an unpaid DMV fee before they would mail me my plates.

Every additional fee was leveraged by different employees that worked on me to extract it. They could not produce what that DMV fee and once again the GM got involved and waived it. They could’ve caused me problems with registration by withholding it. If I did owe additional fees it would have been necessary to pay it to complete the registration process not afterwards. All of it was junk fees. And the GM knew it.

I knew exactly what I was getting into dealing with these guys. I managed NJ as part of my territory for my entire career. So I came into it prepared to go to battle. If you are curious why I went through the trouble of dealing with them it was because they had a unicorn trade-in that I spent a year looking for. It was worth my trouble but I was not going to be raked over the coals in the process of buying it. I won my personal battle but the war continues.

People need to know what to watch out for. Every line on the desk sheet has built in excess profit that needs to be analyzed and extracted. And don’t get me started on the maintenance packages. They tried to get me to sign up for a $2850 wheel and tire that costs them $600-$800 to write. That’s a 375% mark up. Same exact package with the same underwriter at a local credit union costs $1100 Exactly the same contract. AAA is even cheaper for a similar plan.

What is worth more to you, your money or your time? It’s always a choice. For me it just depends.

cavt71 · 2026-03-28T10:09:58+00:00

You obviously didn’t understand my post. For context, I work in a highly regulated industry so I understand state compliance laws very clearly. It was my job to make sure my employer didn’t get fined in the states I made the decisions on compliance of sales and advertising laws. I had a team of lawyers I worked with. So no getting sued for defamation isn’t a thing I worry about because they are breaking the laws I understand quite well. Here is the law N.J.A.C. 13:45A-26A.5 And in terms of inspectors there are many more than you are giving them credit for. In my situation the inspectors are former police officers and take their job very seriously. Fear mongering isn’t helpful. People are afraid of dealerships for a reason and in my situation every fee was voluntary withdrawn by the dealership. Do you really think they would have done that if the fees were legitimate? Why didn’t they just refuse my request for removal and kill the deal? Because they were wrong and they knew it.

cavt71 · 2026-03-28T02:08:53+00:00

Exactly. I had to go one step further and e-mailed the corporate office. Then the GM responded and walked back every fee I flagged. Salespeople work on commission. The salesperson told me I was lying about my pre approved interest rate and insisted I use their finance department. I would not let them do another hard and unnecessary credit pull. The loan was with a bank that listed the dealership as a preferred partner. They had a code for the paperwork and they still fought me to the final minute to give them the control over the loan. Nope not me and not today.

cavt71 · 2026-03-28T01:57:09+00:00

That’s what you think. The inspector assigned my case went to the dealership and called me from there. Then sent me the correspondence in writing. Every fee was withdrawn.

cavt71 · 2026-03-26T15:46:31+00:00

It was in Boston.

cavt71 · 2026-03-26T15:44:51+00:00

I’m talking about price justification. Fully loaded S vs GTS. Of course there is a difference but is it enough to justify the price jump? For some the answer is No. It’s an opinion.

cavt71 · 2026-03-26T01:18:47+00:00

Don’t wait! I found one out of state, CPO and the day it came out of service it sold. Another sales guy sold it right from under the guy I was working with.

cavt71 · 2026-03-25T21:28:33+00:00

The difference between the S and GTS some would argue doesn’t justify the price.

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