The Medical Thread: We're experts on everything else; why not?

[jen]

Re: The Medical Thread: We're experts on everything else; why not?

mr les was on the NCAA committee about concussions. Some of the stuff that they are now 'discovering' has been known for awhile. Lots of neurochemical stuff and what constituted sx that were diagnostic. Research was indicating a lot of things back then that no one wanted to acknowledge. One reason mr les refused to let lil les not play ftbl.

another interesting thing I read (a summary from a JAMA article) was the severity of injury is not associated with prolonged recovery. so just because person A was knocked unconscious in a violent car accident, and person B hit their head on a cabinet... it doesn't necessarily mean person A will have a longer recovery.

 

[leswp1]

Re: The Medical Thread: We're experts on everything else; why not?

another interesting thing I read (a summary from a JAMA article) was the severity of injury is not associated with prolonged recovery. so just because person A was knocked unconscious in a violent car accident, and person B hit their head on a cabinet... it doesn't necessarily mean person A will have a longer recovery.

This is very true. One guy on mr les' team took a minor check against the boards. Not a nasty check. He came off saying he felt funny. It took him 11 months to recover. Another kid was blown up in the middle of the ice. Went down like a ton of bricks. Only time in almost 40 yrs I saw mr les hit the ice at a run, calling for the doc as he went. Kid was out and then when he recovered consciousness couldn't remember English and was completely disoriented. Went out boarded via ambulance. Came back a few hours later feeling like a million bucks. Never had a symptom after that evening.

 

[MissThundercat]

Re: The Medical Thread: We're experts on everything else; why not?

July 2, I had surgery to fuse a joint in my right foot. Going on 6 months later, it's still not healed (completely fused), and I'm told the hardware is coming loose inside. I feel like I've been knocked down. I was walking for the most part; now I'm back to using the knee scooter at places like Target. I'm currently unemployed and I wait for an answer as to what kind of work I can do.

 

[leswp1]

Re: The Medical Thread: We're experts on everything else; why not?

So- could put this in a few places but this seems like the best place- If you have had anything medical you are billed for check everything out. In the last yr our local hospital and their medical group have over-billed us by close to 1400$. On 6+ hours of trying to sort things out for things they have over charged, double billed, falsely charged, mis-coded.

-mr les had a preventative screening test billed as preventative but they billed close to $400 for anesthesia under a diagnositic code
-Preventative labs were miscoded to the tune of $300+ . Hours and multiple calls- still trying to sort this out, since before October. If they send me to collections (quite possible) I am going to find out what the stratosphere looks like.
-Preventative yearly visit was billed as a regular visit $200+- and a co-pay- not billable at all.
-The latest- saw NP in a Risk clinic. 3rd time I have been. First 2 times- a copay. This time- 2 bills- $150 and $330 billed for an outpt visit and billed a level 4 visit for a Dr that I didn't see. Called the Billing dept- got shifted thru 4 people. They can't explain who the Dr is. They tell me it may be because NP is under the Doc. Billing under another Provider is supposed to be illegal- fraud- unless the Provider sets eyes on you. They can't explain why I have 2 bills for the same service. They can't explain much of anything. The last person I got shifted to was unavailable so I had to leave a message. My message- no $$ for you unless someone can explain why I have this bill.

Call insurance. I needed a referral. This was "unauthorized" so they billed me. I asked when they called to confirm and again when I went if my referral was in place- yes. Turns out one doesn't exist. If I had one none of this should have been billed except for a co-pay. (I have a PPO but they require a referral or they charge me a rate that is thru the roof.) No one told me this when I asked why I was billed after never having had a bill before.

Now, I have to call the PCP to generate a referral and then I need to call the insurance co to make sure it went thru and then check with the billers to make sure they processed it. It should not be this FVCKING complicated.

Lesson- always double check with the billing dept and the insurance co before you pay a cent. Thank God I was in medicine and have knowledge of billing, codes and what is covered. Can't imagine what other people do.

Even worse- we have had issues with this hospital before so I called insurance and the Practice BEFORE getting anything done so I would not run into this. Um. Ya.

 

[ScoobyDoo]

Re: The Medical Thread: We're experts on everything else; why not?

So- could put this in a few places but this seems like the best place- If you have had anything medical you are billed for check everything out. In the last yr our local hospital and their medical group have over-billed us by close to 1400$. On 6+ hours of trying to sort things out for things they have over charged, double billed, falsely charged, mis-coded.

-mr les had a preventative screening test billed as preventative but they billed close to $400 for anesthesia under a diagnositic code
-Preventative labs were miscoded to the tune of $300+ . Hours and multiple calls- still trying to sort this out, since before October. If they send me to collections (quite possible) I am going to find out what the stratosphere looks like.
-Preventative yearly visit was billed as a regular visit $200+- and a co-pay- not billable at all.
-The latest- saw NP in a Risk clinic. 3rd time I have been. First 2 times- a copay. This time- 2 bills- $150 and $330 billed for an outpt visit and billed a level 4 visit for a Dr that I didn't see. Called the Billing dept- got shifted thru 4 people. They can't explain who the Dr is. They tell me it may be because NP is under the Doc. Billing under another Provider is supposed to be illegal- fraud- unless the Provider sets eyes on you. They can't explain why I have 2 bills for the same service. They can't explain much of anything. The last person I got shifted to was unavailable so I had to leave a message. My message- no $$ for you unless someone can explain why I have this bill.

Call insurance. I needed a referral. This was "unauthorized" so they billed me. I asked when they called to confirm and again when I went if my referral was in place- yes. Turns out one doesn't exist. If I had one none of this should have been billed except for a co-pay. (I have a PPO but they require a referral or they charge me a rate that is thru the roof.) No one told me this when I asked why I was billed after never having had a bill before.

Now, I have to call the PCP to generate a referral and then I need to call the insurance co to make sure it went thru and then check with the billers to make sure they processed it. It should not be this FVCKING complicated.

Lesson- always double check with the billing dept and the insurance co before you pay a cent. Thank God I was in medicine and have knowledge of billing, codes and what is covered. Can't imagine what other people do.

Thanks for posting this. I find it pretty fascinating that "keep your doctor" really means "call the insurance company first to make sure it's covered".

 

[leswp1]

Re: The Medical Thread: We're experts on everything else; why not?

Thanks for posting this. I find it pretty fascinating that "keep your doctor" really means "call the insurance company first to make sure it's covered".

Part of the ACA was supposed to make billing more understandable. The GOP gutted that. I have close to 30 yrs in Primary Care and even with all my diligence it still screws up every time. Stuff like Preventative codes are multi-part. If you have a test for Lipid screen you need more than one code to get it covered. If one is missing you get charged big $$. Same for a number of other screening tests. Some of them are covered only with certain age groups or populations.

Coverage can also be at the whim of your HR dept. I had a pt once who had a new onset heart murmur with some other stuff going on. They needed a cardiac echo. The plan they had specifically excluded that test. No reason. Other more complex testing was covered. I always told patients they had to call before getting tests. This person didn't. They ate an $800 bill. Also had patients who were in dire need of testing turned away at the site because they couldn't fork over cash. Nothing like getting a call telling you the patient has left because they didn't have the money for the test you needed to help decide what the next step in the plan was.

 

[Stauber1]

July 2, I had surgery to fuse a joint in my right foot. Going on 6 months later, it's still not healed (completely fused), and I'm told the hardware is coming loose inside. I feel like I've been knocked down. I was walking for the most part; now I'm back to using the knee scooter at places like Target. I'm currently unemployed and I wait for an answer as to what kind of work I can do.

Sorry to hear your healing isnt going as you had hoped. Last Feb. I had fusions in 2 spots in my right foot, 7 screws and a plate. It still doesnt feel right and has been incredibly frustrating. I also had to spend way more time out of work than I wanted to/could afford, so I know that feeling as well.
Not sure I have any advice are consoling words for ya...I guess just letting you know I feel your pain, so to speak.

I keep trying to tell myself at least I have all my arms, legs, hands, feet, and digits and as frustrating and debilitating as this has been there are people who have to deal with worse.

But that seems to only offer fleeting consolation to a guy who has been playing and training soccer basically year-round, 3-6 days/week since the age of 12, and now hasn't been able to play at all for over 2 years.
(Took over a year after the injury to find someone who could accurately diagnose what was wrong).

Hang in there. I know you love running, and maybe you have to start looking for other ways to be active, or adjust expectations of what you are physically capable of, or develop a new outlet for your passion. I think that is just something that comes along with getting older, and it isn't the end of the world...

But if you figure out how to do that let me know your trick.

 

[MissThundercat]

Re: The Medical Thread: We're experts on everything else; why not?

Sorry to hear your healing isnt going as you had hoped. Last Feb. I had fusions in 2 spots in my right foot, 7 screws and a plate. It still doesnt feel right and has been incredibly frustrating. I also had to spend way more time out of work than I wanted to/could afford, so I know that feeling as well.
Not sure I have any advice are consoling words for ya...I guess just letting you know I feel your pain, so to speak.

I keep trying to tell myself at least I have all my arms, legs, hands, feet, and digits and as frustrating and debilitating as this has been there are people who have to deal with worse.

But that seems to only offer fleeting consolation to a guy who has been playing and training soccer basically year-round, 3-6 days/week since the age of 12, and now hasn't been able to play at all for over 2 years.
(Took over a year after the injury to find someone who could accurately diagnose what was wrong).

Hang in there. I know you love running, and maybe you have to start looking for other ways to be active, or adjust expectations of what you are physically capable of, or develop a new outlet for your passion. I think that is just something that comes along with getting older, and it isn't the end of the world...

But if you figure out how to do that let me know your trick.

Yesterday, I was sitting in church and realized I had to walk away from running. I trained and raced year round, including running a marathon in the middle of winter. I just realized I couldn't do it any more. But I've been leaning more toward swimming and riding my bike now, as well as looking for intense workouts with little to no impact. Once I get established in a job, I will be getting a pool membership and swim lessons, just so I can do things like Swim to the Moon 5K near Ann Arbor and the Big Shoulders 5K swim near Chicago. And with my bike, there are events like any distance at the Holland 100 and the MSU Gran Fondo. I'll be okay in the long run, even if I look like a hot mess right now.

 

[ScoobyDoo]

Re: The Medical Thread: We're experts on everything else; why not?

Part of the ACA was supposed to make billing more understandable. The GOP gutted that.

Shocking.

 

[St. Clown]

Re: The Medical Thread: We're experts on everything else; why not?

July 2, I had surgery to fuse a joint in my right foot. Going on 6 months later, it's still not healed (completely fused), and I'm told the hardware is coming loose inside. I feel like I've been knocked down. I was walking for the most part; now I'm back to using the knee scooter at places like Target. I'm currently unemployed and I wait for an answer as to what kind of work I can do.

Small tangent to this as your situation is much more involved than mine ever was or will be: I broke the big toe on my left foot back in the autumn of 2015 while out for a run, going downhill and trying to slowdown for all the leaves on a forested path. The end bone of my toe split into a V shape, per the x-rays. While walking to work today, the joint of that toe started bothering me again. I swear this won't ever go away.

 

[BassAle]

Re: The Medical Thread: We're experts on everything else; why not?

Yesterday, I was sitting in church and realized I had to walk away from running. I trained and raced year round, including running a marathon in the middle of winter. I just realized I couldn't do it any more. But I've been leaning more toward swimming and riding my bike now, as well as looking for intense workouts with little to no impact. Once I get established in a job, I will be getting a pool membership and swim lessons, just so I can do things like Swim to the Moon 5K near Ann Arbor and the Big Shoulders 5K swim near Chicago. And with my bike, there are events like any distance at the Holland 100 and the MSU Gran Fondo. I'll be okay in the long run, even if I look like a hot mess right now.

I think this is a good decision for you. Unfortunately we sometimes have to walk away from activities we love. Hopefully you find as much enjoyment in cycling and swimming.

I'm currently having chronic ankle pain due to a multiple sprains when I was younger (the worst was about 20 years ago). Hiking is one of my favorite activities, and I can still do it okay but I need to be very careful because my right ankle is injury prone. Stiff hiking boots help. I haven't run any significant distances in years and I recently bought a nordic track studio cycle (their version of the Peloton), which I am enjoying. I'm starting physical therapy this month, and hoping to at least be able to run my companies 5k with my kid this summer.

 

[leswp1]

Re: The Medical Thread: We're experts on everything else; why not?

This should be called the I am broken thread.
Dislocated my midfoot Labor Day of 2017. Still have days when it feels like it shifts out of place. Trying to walk and making it out most days but there are some days my body objects. Trying to think of it as doing better than nothing is better than nothing. Lil les (who ain't little anymore) runs 10-15 miles a day. I am happy to walk 2.5 miles and know I will ache after.

 

[MissThundercat]

Re: The Medical Thread: We're experts on everything else; why not?

Another thing that's upsetting me about my foot is it's greatly impacting my job search. I was briefly employed as a Behavior Technician, but that didn't work out, and I was set to take a temp job in a factory to just get some income in. Now my surgeon wants me in a job where I'm sitting down. He didn't say no to factory work, but let's just say a sit down job would be highly encouraged.

 

[MissThundercat]

Re: The Medical Thread: We're experts on everything else; why not?

At least I'm getting a bone stimulator to help with my foot, and I'm not paying a dime out of pocket for it. Tomorrow, a representative will meet me and show me how to use it.

 

[jen]

Re: The Medical Thread: We're experts on everything else; why not?

I'm still broken.

I had dry needling (neck) today and it was very... challenging. Painful. Sometimes I pass out when they draw blood (but not if I lie down), so I thought it'd be OK, since I would be lying down... ugh. I didn't pass out, but I came close. But I'm sticking (ha ha!) with it, because I think it will be helpful in the long run. Anyone had it done?

 

[LynahFan]

Oh, boy.

A couple months ago, I got another of those annoying deep zits on my nose that I get from time to time. This one got really infected, though, and wouldn’t go away. Being busy with travel and work and babies (2 under 2), I made it to urgent care for some antibiotics a couple times, but couldn’t get in with a dermatologist until today. He took one look and said, “that’s no infection.” So whatever that thing that grew from nothing to a nickel size in 8 weeks is off at the pathology lab.

Fingers crossed....

Whew.

8 weeks, 4 biopsies, 2 dermatologists, 2 oncologists, and one cancer center later, they concluded that it was......a “normal” immune system overreaction to an infection. They all seemed quite surprised - they really thought it was going to be a cutaneous lymphoma.

All in all, not a terrible first experience with the health care system, but man am I glad I have great insurance.

 

[dxmnkd316]

Re: The Medical Thread: We're experts on everything else; why not?

Good to hear. As someone who went through a very similar experience a year ago this month, I can tell you our health care system is great, it’s completely broken, and I’m glad I have insurance.

Terrifying experience that defined and galvanized the relationship between me and my soon to be wife.

 

[walrus]

Re: The Medical Thread: We're experts on everything else; why not?

Whew.

8 weeks, 4 biopsies, 2 dermatologists, 2 oncologists, and one cancer center later, they concluded that it was......a “normal” immune system overreaction to an infection. They all seemed quite surprised - they really thought it was going to be a cutaneous lymphoma.

All in all, not a terrible first experience with the health care system, but man am I glad I have great insurance.

Nice, I've had Melanoma, Squamous Cell and basil cell removed from various spots on my body. Thankfully all gotten early enough.

 

[jen]

Re: The Medical Thread: We're experts on everything else; why not?

Brains are amazing, episode 2478625: <a href="https://www.healthline.com/health/agnosia#types">Agnosia Types</a>.

This hasn't happened to me, but happens sometimes in post-concussion issues. So your brain can decide an object isn't there, and then it IS there? Wow. It amazes me the kind of specific things that can go haywire.

if your brain can't process the object's existence, is it really there? what happens if you touch it?

 

[St. Clown]

Re: The Medical Thread: We're experts on everything else; why not?

Does anybody have a good resource/method for tracking down medical costs (like delivering a baby)?