Tag Archives: doctor

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.
Advertisements

Stitch removal

10 Apr

After my morning classes, I went to University Health Services to get the stitches removed from my lip and my chin. After waiting in the lobby for a short while, I was seen by the triage nurse, who I’ve learned is responsible for prioritizing patients based on the severity of their conditions. The triage nurse today was actually the same nurse who had bandaged my wounds on Monday, so she was somewhat familiar with my story. On Monday, though, I had been able to talk reasonably well, but today it’s very hard for me to convey information to other people, so I was relieved at not having to repeat my whole story.

I was kind of annoyed when the triage nurse asked how I was going to get enough food with my mouth wired shut and then added “You’re already such a little guy.”  I’m about 6′ 1″ tall, and I weighed 155 pounds when I stepped on a scale during spring break. I certainly don’t consider myself to be big, but this was the first time in a long time that anybody described me to my face as “little.” I could afford to lose ten pounds before I’d be classified as underweight. The remark seemed particularly inappropriate coming from somebody who was supposed to be giving me a medical evaluation. I mean, if I had stepped on a scale, then it might be appropriate to bring up my weight, but I think it’s reasonable for me to expect the nurse not to make uninformed comments on health-related issues. I know she meant well, but it still seems inappropriate to me.

After the triage nurse, I was seen by a doctor and a nurse. I was amused that the doctor who looked at me asked if my bicycle was damaged. I did my best to tell him that it wasn’t even scratched, although I haven’t cared enough to look at it. The nurse took out the stitches. She had a fair amount of trouble with this because the thread on my chin was the same color as my facial hair, which I’ve been unable to shave since the accident.

I went into UHS hoping to ask somebody whether I should be concerned about the pain I’ve been experiencing in my left ear. I think it’s probably just swelling around the site of the fracture, but I wanted to check. Unfortunately, I wasn’t able to communicate this question to anybody. Looking back on the visit, it seems like somebody should have recognized the obvious difficulty I was having in communicating and offered me a pen and paper to write down my answers. On the other hand, perhaps I should have brought my own pen and paper.

Monday doctor visits

6 Apr

I called the oral surgeon’s office as soon as they opened at 8AM. They were able to make an 11AM appointment for me, but they told me that  I should get a referral from University Health Services (UHS) so that my student health insurance plan would cover treatment. I called UHS, and they told me that I should come to urgent care to get my authorization.

I very much resented being required to get this authorization. It seemed ridiculous that they couldn’t just trust the emergency room doctor’s word that I needed to see an oral surgeon. I spent the better part of an hour waiting at UHS before seeing a nurse and then a doctor. The nurse took my temperature and my blood pressure (both were normal) and asked me a few questions about my accident and the injuries. She showed me a piece of paper with faces showing various levels of discomfort and had me rate my pain according to the numbers labeling the faces. However, there were two sets of labels, one from 1-10, and one from 0-5. I didn’t ask which one she wanted me to use, but I said my pain was about a 2. For the most part, my injuries have been a bit uncomfortable, but not particularly painful.  The doctor looked at my various injuries and had another nurse bandage my scrapes. This actually made me rather glad to have come in because I had so many scrapes and not enough energy to bandage all of them. The nurse also gave me material for dressing my wounds for the next five days before I go back to get my stitches removed. I left with a bill of $15.60 not covered by insurance. Most of that was for the bandages the nurse had given me, which were $55 before insurance  (and $11 after).

About an hour after getting out of UHS, I had my appointment with the oral surgeon. He seemed nice and friendly without being intrusive (and, as a somewhat shy individual, I’ve found a lot of medical professionals to be intrusive). He showed me my x-rays, and explained my fracture, a condyle mandibular fracture. I was mildly disgusted when he told me that the model skull on which he was pointing out the condyle, a thin part of the mandible near the joint, was a real human skull, and I became altogether horrified when he removed the jaw from the skull and asked me to hold it.  He told me that the condyle fracture was a common type of fracture, which usually was treated without open surgery. The usual treatment was to anesthetize the patient, prod the bone back into place, and wire the jaw shut for a few weeks. In a small proportion of cases, however, this doesn’t work, so an open surgery is necessary. He added that there was a small number of cases in which it isn’t necessary to wire the jaw shut; sometimes the bone will stay in place well enough that  it is sufficient to keep the patient on a liquid diet. He didn’t specify any time frame for the liquid diet, so I asked if this liquid diet would be for the rest of the patient’s life. “No, just a few weeks.” he answered, laughing.

In my case, the surgeon said, it will be necessary to wait a few days until my face is less swollen to do anything. He wasn’t sure whether it will be necessary to wire my jaw, and he won’t know until he has me asleep in the office. He told me he would have his receptionist call me in the afternoon to set up an appointment.

The oral surgeon also expressed concern about my two chipped front teeth. I told him that I was planning on having them fixed, but I thought that the broken jaw was a more pressing concern. He agreed, but said that I should have a dentist put a temporary seal on it. He said that since I had only  lived in the area for seven months, he couldn’t imagine that I would have had any reason to find a dentist by now. I was more than a little bit amused by this, having long been told that I should have a dentist clean my teeth every six months. I said, that I had, in fact, found a dentist, and I told him who it was. The oral surgeon told me that my dentist was a great dentist, and then made an appointment with the dentist for me that afternoon.

I also asked the oral surgeon if he had any suggestions for keeping my mouth clean if my mouth were wired shut. He suggested getting a children’s toothbrush and Sensodyne toothpaste. I wasn’t crazy about the Sensodyne suggestion, but I decided to get a children’s toothbrush to use with my usual Tom’s of Maine toothpaste.

I had plenty of time to get to the dentist’s office, but somehow I still ended up running to catch the bus to get there. This certainly wasn’t a good thing for me to be doing with broken jaw, but I didn’t fall, and I did catch the bus. When I got to the dentist’s office, he put a seal on one of the teeth, which he said almost had a nerve exposed. He said that both of the teeth were only chipped in the outermost layers, and he expects that they will be fixable. However, we’ll have to watch them carefully, and they may end up needing root canal work.

I repeated the question about keeping my teeth clean to the dentist, and he suggested a Water Pik, so I added that to my shopping list, too.

About twenty minutes after I got out of the dentist’s office, I got a call from the receptionist at the oral surgeon’s office. She told me that the next two appointments available were Wednesday of this week and Tuesday of next week. She added that she’d have to check with the surgeon to see if Wednesday would be too soon and call me back later. She also told me I’d need a friend to drive me home from the procedure, so I headed into the office to find somebody who could do that for me.

I was relieved to learn when the receptionist called me back a couple of hours later that the surgeon will be able to do the procedure on Wednesday. Although I’m not in pain most of the time, there are enough positions that are quite painful, that I’d really like to get it done as soon as possible. After scheduling the appointment, the surgeon transferred me to another member of the office staff, who told me that their office didn’t contract with either of my health insurers, and she told me the cost of the service, which was just under $3700. I knew that my insurance would cover some of the costs, even if it was out of network, but I wondered why I was referred to an out-of-network doctor in the first place. I know I’ll be able to afford whatever it costs, but of course I’d rather pay for as little as possible.

%d bloggers like this: