Pretty soon you're talking about real money

[George K]

@bachophile said in Pretty soon you're talking about real money:

Situs inversus.

Look it up

Ever seen it? We had one for a CABG - really screwy from what I understand (I wasn't the gas passer on that one).

[Horace]

Yesterday I had a followup appt with the doctor, but ended up only seeing his physician's assistant. We got to discussing the next surgery and I asked where it would be done, and mentioned my issues with the previous place. He was pretty shocked to hear of the 98k bill my insurer received. As always, nobody on that side of the issue ever knows about the money issues. (One of the many symptoms of the total lack of market forces in these transactions.) Apparently what I told him got back to the surgeon, who then apparently called the surgery center and gave them a dressing down. The surgery center then called me to try to smooth out any issues I may have had. This doctor and his group is an important customer of theirs and they can't afford to be pissing him off, so all of a sudden it became priority to make sure I'm happy. The surgery center told me that even though they're out of network, they check with the insurer and only charge the patient what the in-network charge would have been. Since I was allegedly below my out of pocket limit for the year, they charged me 1400. I asked whether that 1400 contributes to my out of pocket total, since that payment was made without my insurer's awareness, and she said yes but maybe she'd double check anyway. I let her know that the whole system of billing as out of network and charging the patient separately as if they had paid in-network, did not fill me with confidence that my expenses were being properly tracked and accounted for. Today she called back and told me that I had been overcharged for my previous surgery, and that my out-of-pocket actually had been met, so sorry, so she'll be giving me my 1400 back. My next surgery will be at this same place, and I am to disregard any bills I may see on my insurer's website, because for some reason my insurer lets me know whenever a provider bills them for services provided to me. Imagine that.

My wife sometimes asks me how the insurance system works for health care in America. I try to convey that it's a chaotic mess that must be negotiated anew every time you need medical services, and if you don't pay attention, you get screwed.

[Jolly]

I once paid for a high-deductible Blue Cross policy on my son. Not because he would probably need it, since 20-somethings don't usually meet $10k deductibles.

It's because even if you haven't met your deductible, you pay the network negotiated price.

[Horace]

If your provider is in-network. Otherwise you're subject to the whims of the billing department of the provider.

[89th]

Thanks for the update @Horace !

[taiwan_girl]

@Horace How is your thumb doing? Any improvement?

[Horace]

You're welcome 89th.

TG it's way more scarred up and way less sensitive to touch and still completely non-functional. Best case scenario is getting worse and worse. I'll know more after this next, last surgery. They may attach a different tendon to the thumb, or they may fuse the thumb at a slight angle so at least I'll have some gripping functionality even with no movement.

[taiwan_girl]

@Horace said in Pretty soon you're talking about real money:

You're welcome 89th.

TG it's way more scarred up and way less sensitive to touch and still completely non-functional. Best case scenario is getting worse and worse. I'll know more after this next, last surgery. They may attach a different tendon to the thumb, or they may fuse the thumb at a slight angle so at least I'll have some gripping functionality even with no movement.

WOW!!! I feel bad for you. Sending the good thoughts to you!!!

[Horace]

Thanks TG. It's ok, I'm already used to it.

[Rainman]

Horace, I forgot. How did you initially injure your thumb, and is it your dominant hand?

Hate to be pushy (not), but are you sure that there isn't a surgeon out there somewhere that could pull off a miracle and fix it back to almost normal? Another state, another country, somewhere where the procedure reflects the latest and greatest?

If I were in your situation, I'd be devastated, given that piano thing I've got.

Best Wishes from the Thin Man.

[Horace]

I cut the tendon at the inside crook of the thumb, on some broken glass. The repair is time-sensitive. If the first surgery had worked, it would have been fine and more or less back to normal. For some reason the repair did not take though. The tendon just fell apart again immediately after the surgery. I don't know how or why. After that, there was a very long waiting period where the surgeon and physical therapist were wishfully thinking the thumb to start moving again. That did not work, and I got a second opinion. The second doctor had an ultra-sound machine (the first did not) and was able to verify the discontinuity of the tendon. We scheduled a surgery quickly but by then there was too much scarring for a "tommy john" surgery where he would have used another tendon, a spare that God put there for this reason, to splice into the ends of the ruptured one. So instead, he put a synthetic sheath in there, and that's been healing there for a couple months. The next surgery, he will attempt to use yet a different tendon, detach it from where it's supposed to be, and attach it to my thumb. Failing that, he will fuse the joint.

It's not really a downer. It hasn't changed my life much. I now hit the space bar with my left thumb rather than my right thumb. Lucky they make them so wide, under my thumb. There are times in my life where I would have been more depressed about it, such as when I had piano aspirations. When I can get back to lifting weights I'll have as much function as I need.

[jon-nyc]

There’s some fun left hand piano repertoire out there since right hand injuries are not uncommon among pianists. Some of it was written for or commissioned by Paul Wittgenstein, brother of Ludwig, who was a concert pianist who lost his arm in the war to end all wars.

Some of my favorites are Scriabin Op 9, especially the prelude, some of the Godowsky/Chopin etudes, and of course the Brahms/Bach Chaconne.

[Horace]

I struggle to love much of the classical repertoire as it is. I suspect I would be batting zero in an attempt to love the left handed stuff. If I do play again, it will be with both hands, trying to work around a compromised right thumb.

[Rainman]

@Horace
Makes me wonder if playing piano might be the best thing for getting your thumb as good as you can get it. In time, of course.

I had a friend in grad school that had a devastating wrist injury from a car accident. He could play piano remarkably well, as somehow he found ways to compensate for wrist movements he could no longer do.

[Friday]

Horace, best wishes for your upcoming surgery. Hope this attachment works.

[Horace]

Thanks Friday! Rainman, that's a good idea, maybe piano would be great physical therapy.

[Aqua Letifer]

@Friday said in Pretty soon you're talking about real money:

Horace, best wishes for your upcoming surgery. Hope this attachment works.

+1. Please provide updates.

[jon-nyc]

@Horace said in Pretty soon you're talking about real money:

I struggle to love much of the classical repertoire as it is. I suspect I would be batting zero in an attempt to love the left handed stuff.

Philistine.