Archive | June, 2009

Twelve week billing update

30 Jun

It was a quiet week on the billing front with only one piece of mail coming in. I certainly can’t complain. Anyway, I took care of some of my outstanding obligations, too. Here’s what’s new:

  • I received a bill from Berkeley Emergency Medical Group for services performed in the emergency room, in particular the following:
    • “ER INTERMEDIATE EXAM” – My best guess is that this is just the doctor looking at my injuries. The full charge was $349, there was an adjustment of -$229.76 (presumably this is the difference between the network rate and the full charge), and insurance (the UC Berkeley plan) paid $95.39, leaving me with $23.85.
    • “INTER REP UP TO 2.5CM” – I think this refers to the suturing of my chin. I don’t know what “REP” stands for, though. In any case, the full charge was $527, but the insurance adjustment took off $329.60 and insurance paid $157.92, leaving me with $39.48.
    • “SIMPLE REP UP TO 2.5” – I think this refers to the suturing of my lip. The charge was $303, the insurance adjustment took off $238.16, and insurance paid $51.87, leaving me with $12.97.

    • The bill read a balance of $76.30, which doesn’t seem too bad, but I just sent them an email with my other insurance information to see if they can get that plan to pay some of this balance.

  • I filled out the form from Meridian Resource Company about accident liability online. I also emailed Bay Imaging Consultants with my second insurance information. When I say that I did these things, I mean that I did them within the last half hour. The good thing about me doing these weekly updates on billing is that it gives me an artificial deadline to meet my responsibilities. I feel like I should make some progress from week to week so that I won’t seem irresponsible to any hypothetical readers.

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Eleven week billing update

22 Jun

I decided to consolidate billing-related posts into a weekly digest from now on. I’d like to be able to say that it’s because I’m too busy to write a new post every time a bill comes, but that would be a lie. The only reason I can offer is that I was tired of thinking of titles for posts about billing.

With that said, here’s what’s happened in the last week.

  • I received a statement from my oral surgeon. It was dated June 10, which was the day I had the arch bars removed. It was addressed to my father, but at my address, apparently a result of confusion over the fact that one of my insurance policies is through my father. The statement said that I had a balance of $1,963.18 which was “Due Now.” This number is apparently the $1,888.18 for the surgery left unpaid by the UC Berkeley insurance plus a $75 fee for the office consultation the day after the accident. I had expected my second insurance plan to pay something, so I was a little bit surprised to see the whole amount due now. The statement also stated that interest of 18% per year would be charged after 60 days and that my entire balance was 61-90 days old. This latter measurement apparently began from the date of service rather than the date of billing.I called the office of the oral surgeon to see if they had billed the second insurance company. I was told that they had, that I would receive another statement after the insurance had paid, and that no interest would be charged until then. The statement I received was apparently “just an updated statement,” which apparently means I can ignore the part about the balance being due now.
  • I also received a letter from Meridian Resource Company, LLC, on behalf of Anthem Blue Cross seeking to determine whether somebody else may be liable for some of the charges from the oral surgeon’s office. The only way I can imagine that this would be the case is if the road condition were such that the City of Oakland were liable, but I doubt that this is the case.
  • I still have a bill from Bay Imaging Consultants for $53.79. They seem to have not billed my father’s insurance, so I should get them to do so. I’ve been lazy about it, though, because the bill doesn’t have a due date.

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Bleeding gums

19 Jun

When I had the arch bars removed, I was promised that my gums would bleed easily for the next two or three weeks, particularly when I flossed. The gums have recovered faster than I expected, though. They bled in about three places the first night of flossing and two places for a couple of nights thereafter. There was one spot that bled for a couple more nights, but by now the bleeding has stopped altogether.

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Loose ends, Part I

16 Jun

With my recovery nearly complete, my posts here will be less frequent than they once were. I’ll still be posting about billing and insurance when there’s news on that front. I’ll also post updates on any new developments with my injuries if and when things arise. Eventually, I’ll get around to posting about some of the things I’ve learned from my accident and its aftermath (including a guide for those who are recovering from similar injuries) and how my experiences have influenced my worldview.

In the mean time, there are a few things that I probably should have mentioned a while ago. I’ll post three here. I may include more in subsequent posts.

  • Some time after I returned from my oral surgery, I found an x-ray of my mouth among the things that I had carried home from the surgeon’s office. I have never had any recollection of the taking of the x-ray, but it was apparently done after I had my mouth wired, as the wires are visible. Here it is. Note that the left side of my mouth (with the fracture) appears on the right side of the image.
    x-ray
  • It seems that I’ve neglected to explain that the part of my jaw that I broke, the condyle (or maybe it was the neck of the condyloid process, just below the condyle) is located near the joint with the upper jaw, rather than near the teeth. I suspect that this made the recovery easier than it otherwise might have been because the pictures of jaws broken between the teeth look far more gruesome than anything I saw on my own face.
  • A few days after the oral surgeon wired my mouth shut, my mother mentioned to me that she had read that people who have their jaws wired shut often have to carry wire cutters for emergency use. I had no recollection of the oral surgeon saying anything to me about wire cutters, but I could not rule out the possibility that he had said something but I could not remember because I was still feeling the anesthesia. Furthermore, some research showed that my mother’s claim was correct. Moreover, I discovered a few days before my wireless upgrade that the instructions I received from the hospital said,

    If your jaw was wired shut, it is important that you be able to open the wires in any emergency that makes it difficult to breathe, such as vomiting, extreme coughing or choking. Therefore, you must carry a pair of small wire-cutters with you at all times. Be sure you know which wires to cut in case this is necessary. If not, ask your doctor.

    To be clear, this came from the hospital, and I had my jaw wired a few days later by an oral surgeon at a different practice. But I never carried a wire cutter. I’m still alive today. Go figure.

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Ten weeks

14 Jun

My accident was ten weeks ago today. With the teeth having been repaired and arch bars off, there are no obvious visual signs of serious injury remaining. I do still have scars from the road rash on my elbows and hands. My facial wounds healed long ago, but I’m finding that the bump on my chin where I had stitches is very prone to getting cut when I shave.

I sometimes get a tingly numbness on the left side of my face, but this seems to have grown more slight over the past few days. Occasionally, I feel a little discomfort (which I would not describe as pain) on the left side of my jaw. I do get a little bit of pain on the right side of my jaw when I open my mouth very wide, but I think it’s just a pulled muscle. Sometimes I also get a soft sound coming from the left side of my jaw when I open or close my mouth. The best word I can think of to describe it is a creaking sound, but I don’t think that captures it perfectly.

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The benefits of a metal-free mouth

13 Jun

I’ve quickly come to believe that the best thing about not having arch bars on my teeth is that it’s much easier to keep my teeth clean. Food was always getting stuck in the arch bars and the wires that secured them to my teeth, and it would often take fifteen minutes or so to clean them with the toothbrush and the WaterPik and then dental floss. Without the wires, it’s much easier: I just brush and then floss.

Another great thing about having the arch bars out is that my gums don’t hurt all the time. I can’t remember whether I mentioned this in a previous post, but when I had the arch bars on my gums would always hurt a little bit where the wires touched them. Sometimes the arch bars and wires would move slightly, and then my gums would hurt a bit more. It wasn’t that bad, because I eventually got used to it and stop noticing it, but now that the pain is gone, I notice that my gums feel much better.

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Good enough

12 Jun

I went in to the oral surgeon’s office today expecting to learn some new jaw exercises. In view of my recent reading, I was somewhat skeptical of the idea that my opening was actually going to get better, so I showed up prepared to ask whether it was reasonable to

When the oral surgeon came into the examination room, he asked me how my opening was. I started to answer before he clarified that he wanted to see it. I opened my mouth, and to my surprise, he told me that it was better than he expected. He added that most people can put three fingers in their mouth, and then demonstrated by trying to put three of his fingers in his mouth. The third one didn’t really fit, though. He had me try to do the same, and I was able to put two fingers in easily, but my opening wasn’t wide enough for a third finger.  The oral surgeon said it was close enough,  demonstrated with his fingers that it was only a millimeter or two from normal, and then watched as I opened and closed my mouth a couple of times to make sure that it was opening straight. He said that I “totally qualify” to have my braces taken off and asked if I wanted them removed right then. I wanted little more, so I answered in the affirmative.

The oral surgeon told me that the wires around my teeth would poke my gums as he pulled them out, so he gave me three options for counteracting the pain: nitrous oxide and a numbing gel; nitrous oxide, the numbing gel, and  novacaine; or general anesthesia. I chose the first of these options, and the oral surgeon told me that most people can handle it, adding that it was “like having a really mean hygienist.”

The oral surgeon moved me to another room, where an assistant put gauze in my mouth, spread the numbing gel on my gums, and hooked me up with nitrous oxide through my nose. The oral surgeon came into the room and started to say, “The adventure that began in April…”. He said it in this overly dramatic tone that sounded like it might have come from one of Barack Obama’s speeches (video; see 9:44), but the second half of the oral surgeon’s sentence, “…comes to a close,” was decidedly less dramatic. He then took the gauze out of my mouth, told me to open my mouth, and cut each of the wires on the top of my mouth before pulling them out. It hurt a little bit, but the pain went away when the wire was out, so it wasn’t bad. At this point, I realized that I had actually started breathing through my mouth again, and I wasn’t feeling the nitrous oxide as much. The oral surgeon then removed the bottom wires. Somewhere in the middle of removing the bottom wires, I noticed that I was sweating a lot, but I don’t know if this was nervousness, an effect of the numbing agents, or a result of the room actually being hot.

The oral surgeon turned off the nitrous oxide and turned on a supply of oxygen, and told me that I didn’t need to return to his office, but I could call if I had concerns. He added that I’d be ready to chew the hardest foods (which he identified as crisp apples, hard French bread, and very hard vegetables) around July 4. The assistant gave me a toothpaste and toothbrush and had me brush my teeth. I had brushed before going, so there wasn’t anything but blood on them, but I complied anyway. The assistant told me that my gums would bleed easily for the next two or three weeks, but that I shouldn’t let this keep me from flossing.

Finally, I have some pictures. First up is a picture of my mouth, sans arch bars.

open mouth

It isn’t perfectly straight, but the appearance of crookedness is exaggerated by the fact that my front teeth are not the same length. The second picture is of me trying to stuff my fingers in my mouth.

I tried to stick my fingers in my mouth before I got caught by the vegan police.

I tried to stick my fingers in my mouth. I suppose this endeavor was made slightly easier by the fact of my having slender fingers.

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Teeth cleaning

12 Jun

I just got back from my routine six-month cleaning at the dentist’s office. I only saw a hygienist; the dentist didn’t look at my mouth. To my relief, she didn’t find any cavities. She told me that one of my back teeth has a deep groove in it that will need to be brushed extra carefully, but she emphasized that this was the anatomy of the tooth rather than a cavity.

When my mouth was wired shut, I was unable to brush most surfaces of my teeth, so I find it quite remarkable that I don’t have any cavities. A large part of this, as the hygienist pointed out, is that I’m lucky to have hard enamel. What I don’t owe to luck, I owe to my WaterPik, which proved to be an absolutely indispensable tool for cleaning my teeth and the wires around them.

I also learned that the dentist’s office has already billed my second insurance for the rest of the charges on my account. I should be receiving a bill for whatever they don’t pay in a few weeks. The statement of benefits from the insurance company, however, will probably go to my parents’ address.

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Bills and such

10 Jun

I’ve been out of town for a bit, and I returned home this morning to find some billing-related materials waiting for me.

The only actual bill came from Bay Imaging Consultants Medical Group. as far as I can tell, this has something to do with the x-rays I received in the hospital. This is apparently separate from the radiology item on my statement from the hospital. The bill lists charges for three items: “ORTHOPANTOGRAM”, “SHOULDER COMPLETE”, “FACIAL BONES, COMPL., MINIMUM”. The total charges were $147, but payments from my insurance brought it down to $53.79. The bill doesn’t say, but I’m pretty sure (based on my memory of some paper which I think I have in a big stack somewhere) that those payments come from my UC Berkeley SHIP plan, rather than my parents’ plan (which is supposed to be my primary insurance). I’ll have to give them a call to see if I can get them to bill the other insurer for the remainder.

I also received an explanation of benefits from the university insurance plan for my services from the oral surgeon. The insurance was billed for $3,720, of which $3,200 was for the surgery and $520 was for anesthesia. The insurance company has covered $1,831.82, and they expect me to pay $1,888.18. Of this amount that I’m responsible for, $146.21 is applied to my deductible, $457.95 is my coinsurance responsibility, and $1,284.02 “exceeds the allowed expense and is the member’s responsibility to pay.” For the record, I don’t really understand what all of these words mean, but maybe some day I’ll find out.

I’m hoping that the oral surgeon’s office will bill the remaining balance to my other insurance. I shouldn’t need to remind them about my second insurance, seeing as they called me for information about it while I was still sleeping off the anesthesia from the surgery.

The last related document I received was an explanation of dental benefits from MetLife, which provides my dental benefits for the SHIP plan. This was for the repairs of the chipped teeth. The statement tells me that the fee for my services is ordinarily $372, but the dentist agreed to accept only $286 as part of his participation in Metlife’s Preferred Dentist Program. Metlife reports having paid $208.80, leaving me to pay $77.20. As I understand it, they are applying $25 to my deductible and then paying 80% of what’s left. I’ll have to ask the dentist if they are also billing my parents’ dental insurance. Either that or I will just wait until I have a bill before I do anything.

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New name and address

9 Jun

As of today, this blog has a new name (Shock and Jaw) and address (http://shockandjaw.com). The reason for this change is mainly personal preference. I have a weakness for bad plays on words, but I didn’t think of this name until some time in late May. A secondary reason is that it gives the blog an identity which I can take away from WordPress.com (a platform which I dislike more and more by the day). For now, the old URLs will work, though.

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