Broke my back and need HELP.....

I spoke with Dr. Tsang's nurse today. She told me that the hold up with getting me a back doctor or Orthopedic surgeon, finding one that will take medicare.
 
One must understand Illinois politics to understand why the doctor is having such a hard time. Illinois is going through some really tough times. Tougher then most states due to corruption in politics. Those doctors who do except medicare wait months or longer for payment. You really can not blame the doctor for not taking medicare. its a political thing in Illinois. Those that live in Illinois know what I say is true.
 
1600vw said:
One must understand Illinois politics to understand why the doctor is having such a hard time. Illinois is going through some really tough times. Tougher then most states due to corruption in politics. Those doctors who do except medicare wait months or longer for payment. You really can not blame the doctor for not taking medicare. its a political thing in Illinois. Those that live in Illinois know what I say is true.
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Medicare is federally funded not state AFAIK.
 
Flymeariver said:
Medicare is federal not state AFAIK.
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That is what I thought. But the excuse we get when asking why these doctors will not except new medicare patients, or I am told. I am told its because of the slow payments to medicare from the state. So someone is not telling it true.

I am just telling you what the nurse told me. They " the doctor " can not find anyone to take medicare.

Our health care system is broken.

By the way I love your screen name Justin.
 
1600vw said:
That is what I thought. But the excuse we get when asking why these doctors will not except new medicare patients, or I am told. I am told its because of the slow payments to medicare from the state. So someone is not telling it true.

I am just telling you what the nurse told me. They " the doctor " can not find anyone to take medicare.

Our health care system is broken.

By the way I love your screen name Justin.
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Thanks :).

It seems to me at this point they are just giving you a range of excuses. I have a suspicion that it may be that they have knowledge that surgery may not have positive effects for you at this point. :dunno:
 
Flymeariver said:
[/B]

Thanks :).

It seems to me at this point they are just giving you a range of excuses. I have a suspicion that it may be that they have knowledge that surgery may not have positive effects for you at this point. :dunno:
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:yes:
 
1600vw said:
One must understand Illinois politics to understand why the doctor is having such a hard time. Illinois is going through some really tough times. Tougher then most states due to corruption in politics. Those doctors who do except medicare wait months or longer for payment. You really can not blame the doctor for not taking medicare. its a political thing in Illinois. Those that live in Illinois know what I say is true.
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That is a problem in every State. I agree that the health care system is broken.
 
Flymeariver said:
Medicare is federally funded not state AFAIK.
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Fee for service medicare is run by contractors on behalf of CMS. By law, the contractor has to pay the provider within 2weeks of receiving the claim. AARP supplemental (operated by United) receives the claim from medicare and usually issues payment within a month of the crossover.

The state is not involved in medicare with a commercial secondary. The state runs medicaid, so with 'dual eligible' beneficiaries, the state is involved.

There are other reasons not to accept medicare, tardy payments are not one of them. I find it difficult to believe that there is a problem accessing spine surgery services for someone with medicare+supplemental coverage.
 
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weilke said:
Fee for service medicare is run by contractors on behalf of CMS. By law, the contractor has to pay the provider within 2weeks of receiving the claim. AARP supplemental (operated by United) receives the claim from medicare and usually issues payment within a month of the crossover.

The state is not involved in medicare with a commercial secondary. The state runs medicaid, so with 'dual eligible' beneficiaries, the state is involved.

There are other reasons not to accept medicare, tardy payments are not one of them. I find it difficult to believe that there is a problem accessing spine surgery services for someone with medicare+supplemental coverage.
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Would you then agree that just maybe nothing no one can do and I am being shuffled around because of it?

I would think someone would just say, sorry charlie but you are out of luck. Not shuffle one around.
 
weilke said:
Fee for service medicare is run by contractors on behalf of CMS. By law, the contractor has to pay the provider within 2weeks of receiving the claim. AARP supplemental (operated by United) receives the claim from medicare and usually issues payment within a month of the crossover.

The state is not involved in medicare with a commercial secondary. The state runs medicaid, so with 'dual eligible' beneficiaries, the state is involved.

There are other reasons not to accept medicare, tardy payments are not one of them. I find it difficult to believe that there is a problem accessing spine surgery services for someone with medicare+supplemental coverage.
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Wouldn't the bulk of the payment for this service be covered by Medicare then? If so, then the Physician is getting only a small portion of the balance from the secondary so I could not imagine the state being a large part of the reason to deny patients.
 
1600vw said:
So I guess this does boil down to money.
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Or medical practicality. Have you pondered the pain clinic guys suggested yet? May be a good option instead of constant pain ya know.
 
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Flymeariver said:
Or medical practicality. Have you pondered the pain clinic guys suggested yet? May be a good option instead of constant pain ya know.
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I know this has been a long going thread and really impossible to read the entire thing. I have gone down that road. For over 6 years. It becomes a vicious circle. It ended when I started asking for a drug cocktail. ****ed me off at the time but saved my life.

I learned to control my pain through what I did or in my case what I did not do. Seven or so months ago I ended up back in the hospital and here we are today.

The short of it or summary to date. The very condensed version...lol

The thing with pain meds. I am a shell of a person walking around in a fog. You can do nothing because of the meds. Might as well shoot me.
 
Flymeariver said:
Wouldn't the bulk of the payment for this service be covered by Medicare then? If so, then the Physician is getting only a small portion of the balance from the secondary so I could not imagine the state being a large part of the reason to deny patients.
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80/20 with a deductible of $147 at the beginning of the year for part B (outpatient care) and $1260 for part A (hospitalization).

Some of the AARP plans kick in and pay the deductible, some don't, depends on which plan you have. Once the deductibles are met, the supplemental covers all of the 20% coinsurance. So if a back surgery with pre-op evaluation, imaging and hospitalization racks up $50,000 in reimbursement (most of it to the hospital to cover the hospitalization, implants, OR time, etc), the patient pays $1500.
 
Flymeariver said:
Wouldn't the bulk of the payment for this service be covered by Medicare then? If so, then the Physician is getting only a small portion of the balance from the secondary so I could not imagine the state being a large part of the reason to deny patients.
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The state has nothing to do with this.
 
Medicare is a federal and not a state program, and there are many docs who take Medicare. This is not a money issue we're hearing- it's a personality disorder, and the circular arguments and illogic demonstrate it. Blaming others is also characteristic of a pd.
 
AcroBoy said:
Medicare is a federal and not a state program, and there are many docs who take Medicare. This is not a money issue we're hearing- it's a personality disorder, and the circular arguments and illogic demonstrate it. Blaming others is also characteristic of a pd.
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The doctor tells me or her nurse tells me they can not find a doctor who will take medicare. If you really believe this is an personality disorder, it would be you with this disorder not me.
 
AcroBoy said:
Medicare is a federal and not a state program, and there are many docs who take Medicare. This is not a money issue we're hearing- it's a personality disorder, and the circular arguments and illogic demonstrate it. Blaming others is also characteristic of a pd.
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Denial is not just a river. You sound like so many doctors I have come across. They will look at my records and look me in the face and tell me there is nothing wrong.
I bet you believe the files I posted are not correct.

Like I posted before, you know not what you talk about. Karma is a Bitc#
 
1600vw said:
The doctor tells me or her nurse tells me they can not find a doctor who will take medicare. If you really believe this is an personality disorder, it would be you with this disorder not me.
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I dont know any of the back surgeons in your town, but if you call the Orthopedic Center of Illinois and tell them that you have medicare and that you were told you need a fusion, you'll be on the schedule for one of their 4 surgeons next week.
 
weilke said:
I dont know any of the back surgeons in your town, but if you call the Orthopedic Center of Illinois and tell them that you have medicare and that you were told you need a fusion, you'll be on the schedule for one of their 4 surgeons next week.
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Prove him wrong Tony!
Call them. Please.
 
Not that this matters much but I have a Artifical disc in my back due to a work place injury. It took 6 months to get a MRI. It was confirmed I had a completely blow out disc. It then took another 6 months to get a discagram, confirmed again, the disc was completely blown. I was then sent to a Physc to see it it was in my head, I pointed to the proof it wasn't. All that got me was a MMPI, well 2 since I screwd up the answers. If it was a redundant question I wrote to refer to question x. They didn't think it was as funny as me. So after 3 years I finally got a artifical disc. I understand the runaround, all I can say is it takes a lot of time on the phone and when that didn't work my wife did it. Keep trying and call the center listed above. You can't get a no if you don't ask.
 
weilke said:
I dont know any of the back surgeons in your town, but if you call the Orthopedic Center of Illinois and tell them that you have medicare and that you were told you need a fusion, you'll be on the schedule for one of their 4 surgeons next week.
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I did call the spine center that you see advertise on TV. They flat out told me they do not take medicare. They then said if I had 16 grand they would set up an appointment for me to see if they could help.

I am not sure if this is the same place, but I will find out this morning and will call them and see.
 
weilke said:
I dont know any of the back surgeons in your town, but if you call the Orthopedic Center of Illinois and tell them that you have medicare and that you were told you need a fusion, you'll be on the schedule for one of their 4 surgeons next week.
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The doctor Dr.Tsang wants me to see Dr. Williams belongs to this group. He would not take medicare, or maybe I should say they would not take my medicare.
But the website says they take medicare. What I have found or am told, Doctors that take medicare are not letting new patient in. It has to do with how medicare pays these doctors.

I will call and see what they tell me.
 
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I got me an appointment on the 9th at 8:20 am. I am so happy. I want to shout out...YAA HOOO.I will keep everyone posted to the outcome. I can not wait.

I also found out the heart doctor, I go see the heart doctor on the 19th at 1 pm. I feel like celebrating. I have not been this happy in a long time. You have no idea. Maybe something will get done I am very hopeful.

I will keep everyone updated you can bet on that.

I needed this. YAA HOO....

I even made the appointment with Dr.Williams. Now that I do not understand. But I am not questioning it.
 
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Glad to hear this Tony!

I have been reading your posts and sympathizing with you. Not being able to help I haven't posted anything. This is definitely good news and I hope they can do something for you.

David
 
1600vw said:
I got me an appointment on the 9th at 8:20 am. I am so happy. I want to shout out...YAA HOOO.I will keep everyone posted to the outcome. I can not wait.

I also found out the heart doctor, I go see the heart doctor on the 19th at 1 pm. I feel like celebrating. I have not been this happy in a long time. You have no idea. Maybe something will get done I am very hopeful.

I will keep everyone updated you can bet on that.

I needed this. YAA HOO....

I even made the appointment with Dr.Williams. Now that I do not understand. But I am not questioning it.
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Before you go to the appointment, obtain a CD with the diskogram images, a CD with a copy of your last MRI and the results of your last bone density study (DEXA). It will give the spine surgeon a better idea of whether surgery is the right option for you, what type of surgery he thinks is best and and whether he is the right one to tackle this.

Fill out their intake form before you go:

http://orthocenterillinois.com/pdf/health history.pdf

Btw. dont get offended if your initial visit is with one of his physican assistants. That is how many large surgical practices work these days. A couple of PAs working under the surgeon do most of the pre-operative screening and workup and the surgeon reviews everything at the back end. You may not see him at your initial visit. The better prepared you arrive and the more squared away you are, the more likely it is that he will take on your project.

And by the love of god, dont tell him that you want him to euthanize you if he can't do a surgery to fix all your problems tomorrow. Listen to what he has to say, see his physical therapy and rehab colleague if he asks you to, consider seeing their pain guy to get you tuned up prior to going for surgery.
 
Weilke,
Let me thank you on behalf of Tony. You have been giving him outstanding advice all along. And he even seems to be taking some of it.

weilke said:
Before you go to the appointment, obtain a CD with the diskogram images, a CD with a copy of your last MRI and the results of your last bone density study (DEXA). It will give the spine surgeon a better idea of whether surgery is the right option for you, what type of surgery he thinks is best and and whether he is the right one to tackle this.

Fill out their intake form before you go:

http://orthocenterillinois.com/pdf/health history.pdf

Btw. dont get offended if your initial visit is with one of his physican assistants. That is how many large surgical practices work these days. A couple of PAs working under the surgeon do most of the pre-operative screening and workup and the surgeon reviews everything at the back end. You may not see him at your initial visit. The better prepared you arrive and the more squared away you are, the more likely it is that he will take on your project.

And by the love of god, dont tell him that you want him to euthanize you if he can't do a surgery to fix all your problems tomorrow. Listen to what he has to say, see his physical therapy and rehab colleague if he asks you to, consider seeing their pain guy to get you tuned up prior to going for surgery.
Click to expand...
 
weilke said:
Before you go to the appointment, obtain a CD with the diskogram images, a CD with a copy of your last MRI and the results of your last bone density study (DEXA). It will give the spine surgeon a better idea of whether surgery is the right option for you, what type of surgery he thinks is best and and whether he is the right one to tackle this.

Fill out their intake form before you go:

http://orthocenterillinois.com/pdf/health history.pdf

Btw. dont get offended if your initial visit is with one of his physican assistants. That is how many large surgical practices work these days. A couple of PAs working under the surgeon do most of the pre-operative screening and workup and the surgeon reviews everything at the back end. You may not see him at your initial visit. The better prepared you arrive and the more squared away you are, the more likely it is that he will take on your project.

And by the love of god, dont tell him that you want him to euthanize you if he can't do a surgery to fix all your problems tomorrow. Listen to what he has to say, see his physical therapy and rehab colleague if he asks you to, consider seeing their pain guy to get you tuned up prior to going for surgery.
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I will do all the above.

The last back back surgeon I saw who ordered the discogram would not allow me to do any physical therapy. I want physical therapy and asked for it. He said no. He even told me to throw out my treadmill and never get back on it.

I think you hit the nail on the head. When this other surgeon looks at my records he will find not much one can do. I hope not a pray this is not the issue. We will see.

Dr.Tsang gave me the files I posted of the discogram. I will have to get this CD you speak of. Should I call the records department at the hospital or the radiologist department that did the discogram for this CD?

Thanks I am listening.

Tony
 
Man, I think I 'm even going to have a better day now that I have read this.
Good for you Tony.
 
1600vw said:
Dr.Tsang gave me the files I posted of the discogram. I will have to get this CD you speak of. Should I call the records department at the hospital or the radiologist department that did the discogram for this CD?
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The radiology department should be able to create a CD with the images for you. They shouldn't charge you for it as it is your record and you are taking it for the purpose of further medical care. You should also get a CD with a copy of your last MRI exam, and if you had a CT scan also a copy of that. Back surgeons frequently dont care what the radiologist has to say ;), so getting copies of the reports is not as important as getting the actual images. There may also be a direct connection by which the hospital can send the images to the orthopedic clinic if you sign a release. It eliminates the need for burning a CD and it makes the images available on the surgeons system rather than having to load them off the CD.
 
And, hand carry the CD with you- do not assume they will send it in a timely fashion. The radiologists reports are not as useful to surgeons as actually seeing the images on the disk.

Be aware that with mechanical, or axial, back pain and no signs of radiculopathy or spinal stenosis that surgery is often not the suggested solution.

If billing and funding are an issue, then every hospital has a financial counseling office. You can talk with them about making time payments, etc.
 
He should probably ask for both electronic delivery and a CD. Diagnostic images may well not fit on a CD. Especially modern, high quality images that take thousands of slices. I would expect to pay a small amount if they have to burn a CD. We don't charge for that at our vet clinic, but many do. The law says they can only charge the actual cost of copying the records. E-Mail is usually free.
AcroBoy said:
And, hand carry the CD with you- do not assume they will send it in a timely fashion. The radiologists reports are not as useful to surgeons as actually seeing the images on the disk.

Be aware that with mechanical, or axial, back pain and no signs of radiculopathy or spinal stenosis that surgery is often not the suggested solution.

If billing and funding are an issue, then every hospital has a financial counseling office. You can talk with them about making time payments, etc.
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I'm praying for you Tony, you seem to have found some hope, try to hold on to it, and be patient with them, firmly state you need help but be patient as they try to figure out how to help you.
 
I had about 5in of wet snow on the car this morning. Well, by the afternoon I couldn't walk upright.

I noticed that back-pain makes me crabby.
I think if I had back pain every day, I would be crabby every day.
 
weilke said:
I had about 5in of wet snow on the car this morning. Well, by the afternoon I couldn't walk upright.

I noticed that back-pain makes me crabby.
I think if I had back pain every day, I would be crabby every day.
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Its tough not to be crabby.

Not sure I can make it until Monday. The pain is getting so bad. its so much worse then when I came home from the discogram. I am getting worse everyday.

I came so very close to going to the hospital today. I want to scream.

The doctor told me all records are available for the back surgeon to see on-line, images and all. Now if I can hold out until Monday.

I will keep everyone posted.

Thanks again for all the help and comments, thoughts, and prayers.

Tony
 
1600vw said:
Its tough not to be crabby.

Not sure I can make it until Monday. The pain is getting so bad. its so much worse then when I came home from the discogram. I am getting worse everyday.

I came so very close to going to the hospital today. I want to scream.

The doctor told me all records are available for the back surgeon to see on-line, images and all. Now if I can hold out until Monday.

I will keep everyone posted.

Thanks again for all the help and comments, thoughts, and prayers.

Tony
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Tony, please hang in there until your appointment. I'm just a newly registered member, but I've lurked here for the past 2 years and have read every post in this thread along with other posts of yours on this board and on the EAA/HBA forums. I wanted you to know there are others out "here" who care about your well being, and I truly hope you can find some relief from your pain.

Sending positive thoughts and energy your way,
another Brian
 
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