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Medical pit falls to watch out for

Medical pit falls to watch out for

Old Jan 5th 2010, 7:51 pm
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Default Medical pit falls to watch out for

Right it is unfortunately my lot to have to deal with the US medical system at slightly more than primary care level. I have been referred to an orthopedic surgeon due to a possible trapped nerve in my neck or shoulder. My primary care doctor is unsure exactly what the problem is and feels it is cheaper for me to see a specialist rather them him run lots of tests hoping to find the problem. Talk of an MRI and they cost a lot were included in the conversation.

Only being used to the NHS where you went in and didn't have to worry about the cost are there any questions I should ask the specialist and anything I should be aware off that would prevent my 20% of the costs getting out of hand.
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Old Jan 5th 2010, 8:14 pm
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Default Re: Medical pit falls to watch out for

Originally Posted by lansbury View Post
Right it is unfortunately my lot to have to deal with the US medical system at slightly more than primary care level. I have been referred to an orthopedic surgeon due to a possible trapped nerve in my neck or shoulder. My primary care doctor is unsure exactly what the problem is and feels it is cheaper for me to see a specialist rather them him run lots of tests hoping to find the problem. Talk of an MRI and they cost a lot were included in the conversation.

Only being used to the NHS where you went in and didn't have to worry about the cost are there any questions I should ask the specialist and anything I should be aware off that would prevent my 20% of the costs getting out of hand.


Ask anything and everything you can imagine, you get about 30 mins initial appointment, so ask what could be the causes, effects, long term issues etc etc etc

Chances are they will send you for multitudes of testing anyways. Welcome to American Healthcare!
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Old Jan 5th 2010, 8:22 pm
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Default Re: Medical pit falls to watch out for

Originally Posted by lansbury View Post
Right it is unfortunately my lot to have to deal with the US medical system at slightly more than primary care level. I have been referred to an orthopedic surgeon due to a possible trapped nerve in my neck or shoulder. My primary care doctor is unsure exactly what the problem is and feels it is cheaper for me to see a specialist rather them him run lots of tests hoping to find the problem. Talk of an MRI and they cost a lot were included in the conversation.

Only being used to the NHS where you went in and didn't have to worry about the cost are there any questions I should ask the specialist and anything I should be aware off that would prevent my 20% of the costs getting out of hand.
Make sure you understand what tests the doctor wants to send you for, and where he wants to send you and what other doctors would be involved in the testing (if any). Then call you insurance company to make sure that hospital is covered/in-network, as well as the other doctors involved. Other than that, I'm not sure what else you can do. Unfortunately the docs or hospital isn't going to give you a print-out detailing the prices they'll charge, so that you can then figure out what your 20% would be. At least, I've not heard of them doing that.

If you have deductibles and max-out-of-pocket contributions that need to be met, make sure you know what those limits are so that you can't be overcharged by the doctors. I've had an MRI multiple times, and everytime I've been surprised by what I've had to pay because it has been about as clear as mud getting info on costs ahead of time. Good luck.
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Old Jan 5th 2010, 9:32 pm
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Default Re: Medical pit falls to watch out for

If you can, get in writing who the doctor you are seeing and what they are testing, as well as who will read the scans and actually do the scans.

Phone your insurance company with all those names to see that they are all in network...don't want to find out the facility is in network but the person reading the scan might not be for example.

They shouldn't kick up a fuss doing this in advance

Good luck!
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Old Jan 5th 2010, 9:44 pm
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Default Re: Medical pit falls to watch out for

All advice received appreciated. I am seeing the specialist Monday who is covered by my insurance and I fill follow the advice to make sure as much as I can any future people are in network as well. Fortunately Regence (Blue Cross Blue Shield) makes it very easy to check online who is in network and who isn't.
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Old Jan 5th 2010, 10:46 pm
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Default Re: Medical pit falls to watch out for

Straight off the back, the Orthopedic Surgeon will at some point suggest surgery...it's what they do. If you can at all bear the discomfort, I would suggest something a little less invasive to start with. Have you tried a chiropractor or acupuncturist? The MRI will probably still be needed, but make sure you get your own hard copies, as you can take them to other specialists if you need to.

I was in the same boat as you - neck pain, arm and shoulder numbness etc in which my primary advised a consult with a surgeon. Although my insurance is fine, I was a little put off by the fact that surgery is suggested so freely, so I never followed it up. I also worked in an OR for 5 years and know of the "production line" system which operates there. Yes, surgery can, and does work, but it should be a last resort when less invasive methods have been exhausted.

For me - a combination of a few trips to the chiropractor, stretching, willful correction of bad posture, and a little jogging finally did the trick. I still have my MRI showing my 2 prolapsed discs, but I am now unaware of the discomfort it caused in the past.

Good luck.

Last edited by Scott33; Jan 5th 2010 at 10:49 pm.
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Old Jan 5th 2010, 10:56 pm
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Default Re: Medical pit falls to watch out for

I made it clear I would only consider surgery if all else failed. This guy is a shoulder specialist in a sport injury clinic and my own doctor said he was very conservative with resorting to surgery.

Acupuncture is an option I would hope was available as I have had it for an injury before and it worked extremely well. I'll see what is said Monday it will only be the co-pay for the office visit and if I don't like what is on offer then I can go elsewhere.
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Old Jan 5th 2010, 11:02 pm
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Default Re: Medical pit falls to watch out for

Lansbury, good luck. For what it's worth, my husband's doctor recommended against surgery for his back and he was sent to physical therapy instead. The reason? Little to no benefit from the surgery.

I'm always a bit baffled at these threads. It's not a bad idea to check on costs, etc. in advance but I've never ran into the experiences I read about on here. I guess I should count myself lucky, I must be unaware of the fact that all of my doctors are trying to rob me blind ...
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Old Jan 5th 2010, 11:44 pm
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Default Re: Medical pit falls to watch out for

just double check at every stage directly with your insurance company because doctors and hospitals often don't calculate costs and deductibles very well (and in some cases are clueless about whether your insurance covers a treatment at all).
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Old Jan 6th 2010, 12:10 am
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Default Re: Medical pit falls to watch out for

Originally Posted by lansbury View Post
All advice received appreciated. I am seeing the specialist Monday who is covered by my insurance and I fill follow the advice to make sure as much as I can any future people are in network as well. Fortunately Regence (Blue Cross Blue Shield) makes it very easy to check online who is in network and who isn't.

Just be sure that the doctor who said they will do the surgery is doing it and not sending in an assistant. Happened recently to a friend who was seeing an in-network doctor only to be sent a bill after the colonscopy and removal of ployps for $5,000 because the "assistant" did not take her plan and friend was not told that the doctor would not be the one doing the test/surgery.
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Old Jan 6th 2010, 1:05 am
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Default Re: Medical pit falls to watch out for

Originally Posted by lansbury View Post
Acupuncture is an option I would hope was available as I have had it for an injury before and it worked extremely well. I'll see what is said Monday it will only be the co-pay for the office visit and if I don't like what is on offer then I can go elsewhere.
I had tremendous results with that this year after the car crash. I was pretty wrecked there for a while.
I've got a lovely practitioner over on this side of town.. not too convenient for you I know, but we've got no shortage of them here with the college in town.

Feel better.
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Old Jan 6th 2010, 2:53 am
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Default Re: Medical pit falls to watch out for

I had some arm pain and numbness in my hand last year, first doctor treated it as an arm problem with pain patches - no help.

Second doc said it was a trapped nerve, after muscle relaxants didnt work I was sent for physical therapy, this was very helpful, however after I quit my stressful job the symptoms disappeared completely. Thankfully we were on tricare so no costs other than small dedectable.
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Old Jan 6th 2010, 2:54 am
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Default Re: Medical pit falls to watch out for

Medical pit falls to watch out for?

Surely moving to the U.S. was the first...
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Old Jan 6th 2010, 4:03 am
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Default Re: Medical pit falls to watch out for

Originally Posted by lansbury View Post
All advice received appreciated. I am seeing the specialist Monday who is covered by my insurance and I fill follow the advice to make sure as much as I can any future people are in network as well. Fortunately Regence (Blue Cross Blue Shield) makes it very easy to check online who is in network and who isn't.
If BCBS is your primary coverage, make sure you either A) don't have any other health insurance or B) have notified and identified who will be paying the bills.

My wife had BCBS and Aetna as part of her student coverage and we got in to a pissing match where neither BCBS nor Aetna wanted to be the primary insurer. Resulted in many unpaid bills that had to be resolved. PIA to be sure.
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Old Jan 6th 2010, 4:43 am
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Default Re: Medical pit falls to watch out for

About 20 years ago, I developed severe neck/upper back/arm pain. For the next month I could barely drive my car (couldn't move my neck).

After about a month of visiting doctors with no help, I went to a semi-retired 85 year old chiropractor and he recommended that I should treat the condition by heating up a damp towel (all except the ends) in the microwave oven and wrap it around my neck. He said I should do that for about 20-30 minutes a day with the towel being as hot as I could possibly stand. I asked why only the neck and he said all the pain is coming from the neck.

So I went home and tried it and within 3 days, the problem was completely gone.

Over the next 20 years, the pain has reoccurred about every 6 months and usually I put hot towels on my neck during that day and the problem is gone by the next day. When I don't immediately put the hot towels on my neck, the problem always gets worse.
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