Reflex Sympathetic Dystrophy Support Group

Well,

I've sincerely tried to be grateful for my pain doctor despite the things that are negative (he seems to hate his job). I can only drive so far and have no one that could take me to my monthly appointments, but I'm finding myself more upset with my pain doctor.

Each patient MUST come each month. Excuses will likely get you fired from the practice. We sign pain contracts about our participation and following all of the rules regarding monthly appointments, payment of bills, no refills EVER other than at monthly appointment (NO excuses), must take surprise UA's on an ongoing basis, etc. There are many reasons that you can get fired. What he does for US is injections, like trigger point, and blocks and several quick "prcedures" but not much talking as it's not his style. He does prescribe medications. You must follow strict rules regarding the medications. For the most part I do understand both why he does the contract and why it's very important for patients to keep the rules.

But, he truly hardly talks to me or answers questions. Last week at my monthly appt. he probably spent about 5 minutes talking to me about my pain and spinal cord stimulators. I felt very excited that he actually talked before just checking my pills that we're now made to bring with us every month and writing the prescriptions that he hands me each time. But this is where I have a problem- Of course these guys are paid an arm and a leg when they do a procedure or when they do surgery, but how much should he make on these 2-5 minute appointments?

My appt. was Tuesday last week and Friday night I went out to my maibox and got a bill from my pain doctor. The monthly charge for our appts. is $175.00. Does that sound reasonable to you guys? Then, about every third month we have to have a UA drug test which is now $500.00. I've had two this year so far and will soon have another one. Then, I saw another charge on my June 6 charge which was Psych. Eval and it was $250.00. So, on June 6, a month ago, he saw me for less than 5 minutes, did not ask me ANY questions or do anything at ALL that could be considered a Psych Exam and had his nurse take my UA cup from me before he came in. So, he saw me for 3-4 minutes and then charged me a total of $875.00!!!! I wish I could make that in a MONTH but he did in 4-5 minutes. Is that outrageous or am I out-of-touch? He KNOWS that my financial situation is bleak. I was really angry when I saw the costs, mainly at the $250.00 Psych. Eval that I NEVER HAD! If I "make trouble" I will likely get fired. What should I do? Anything? The only good pain doctors that I know of in this area are his partners and I can't go to them.

What is fair and what is right? Can anyone please tell me what you pay for similar things? I felt so beaten down and stolen from when I saw this bill.

gail

Post edited by: maddiesgram, at: 07/09/2012 02:47 AM

Post edited by: maddiesgram, at: 07/09/2012 02:51 AM

That is ridiculous Gail, I have a UA ever so often too, but 500.00 JEEZ and why do you need the physiological test? I think he is padding, and taking advantage of people in pain, however we must grin and bear it, I don't know how it is there but here there's not very many Pain Dr.'s.

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Post edited by: Rolphster, at: 07/13/2012 02:24 PM

Gail, Psych evals require a licensed therapist counselor or Psych nurse and that a test be given. This could be fraud, not just padding a bill, and I'm not saying your doc is involved in fraud. You don't want an SCS: that would be one rational I could think of for the psych eval. A psych eval is not usually just given for no reason, but in preperation for a treatment proceedure. Your doc may not even be aware that the charges are on the bill.

Rev.

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Post edited by: Rolphster, at: 07/13/2012 02:13 PM

Thanks, you guys, for your replies. If I could leave this doctor I would have been gone long ago. But, I did an extensive search for pain management doctors within driving range of me driving myself and it's a very short list. They also make it almost impossible for you to change. The pain doctors that I called here first want a written letter from your current pain doctor that you will no longer be seen as a patient by them. Second, they will get your files faxed to them and THEN the doctor will decide whether or NOT he wants to take you on as a patient. IF he decides to take you on as a patient, he may or may not agree with your current pain medication plan and may or may not continue any pain medications that you currently take. So, it's like a jump off the Golden Gate Bridge with no nets, life jackets, or promise that you will get help from anyone once you hit the water. If all goes well, you might end up with what you already have, which is pain medications. And, that's it. So, I've stayed. My current doctor told me a couple of months ago when I asked again about ketamine that there was one "guy" (I think he meant a doctor) who did them in Dallas, all by cash pay only up front, and out of a home. He just wanted me to stop asking. He has me on several strong pain medications and I feel completely stuck.

I don't believe the "psych eval" on my bill was a mistake. I believe he grabs every penny he can whether it's deserved or not because HE CAN. What am I going to do? Leave? Well, he's got a waiting room full of other patients... bon voyage! Regarding the UA tests, the $500.00 is a big improvement! Yes, they are sent to an outside lab and the place they went to before 2012 they were $1,800.00 each!!! At least, that's what we were billed. I complained as I'm sure others did, but we only got them about once a year (or I did) and he said in his uncaring way he would look for another lab. So, we ALL had them in January and now he does them about every 3 months- or possibly exactly every 3 months, I can't tell for sure yet. And, now they're "only" $500.00!! I'm suppose to be GRATEFUL that it's so LOW now!

The thing is that I am grateful for the medications I take because they DO bring the pain down and yet I am also totally trapped by them. I have to be able to see a pain doctor who will help me and I've built 4 1/2 years into this and tried to jump through EVERY HOOP out there that I have to do in order to get my meds. I do everything and I mean show up at every appointment early, bring my pill bottles to each appointment, lock my medications in a safe at home, obviously never take any medication other than as prescribed no matter how high the pain, and on and on and on. I don't even HAVE this kind of money, so I talked to his office manager a couple of years ago and I pay $100.00 month extra on my bill which means that when I almost get it paid, another UA happens. I can't even afford medical care other than getting my medications, no PT, no other doctors, nothing, because I pay so much for my medical insurance and then so much for my pain doctor that I'm POOR! I actually run out of money every month and have to borrow from my daugher for food and mediations. My 27 year old daughter took ME to Alabama on my recent trip and paid for the hotel. My son paid for every meal. I literally didn't have ANY money. So, the money to this guy is not easy money. At ALL!

What have you guys done before in trying to get a new pain doctor? I don't want to jump out of the frying pain and into the fire. And, I'm in a town called Anna and there are NO doctors of any kind here. Being a city girl, I was shocked when I moved in to find out there was no police department. Not very comforting for a woman living alone. We did finally get a couple of cops and even some real firemen with real fire trucks. We even have 4-5 pizza places, a Taco Bell, and two dentists. We even got a nail "salon" and a grocery store! But, no doctors. My pain doctor is a 20-25 minute drive and others would be MUCH further.

I think I'll first call and ask to talk to whoever does billing and then say that I believe that there's a mistake on my bill for a psych eval, because I haven't had one. But, what if she says that my appt. WAS a psych. eval? I honestly don't know what to do. What would you guys do?

Thanks!

gail

Again, Gail, a psych eval is a specific thing in medical billing and REQUIRES at least a psychiatric nurse trained in evaluating the TEST. The reason the fee is so great is that this is a test requiring psychological testing and trained psychological or psychiatric personnel. If neither of these were done, you were charged for a medical procedure that was not done. It may have been charged by mistake. I would as you suggest, go in claiming that it was charged by mistake. But if they doctor's office continues to charge for that, go to your insurance company and tell them a charge is being sent to them that was not done.

Gail, why have you not applied for SSDI? There are two Social Security programs for disability: one requires quarters you pay in, the other is for those who are disabled but have not paid in enough quarters. Please check into this.

Rev.

Hi all,

Sorry I can't help on the cost issue. Since I'm in the UK and we've got our handy National Health Service, I don't pay anything (even for prescriptions where I am. I use to have to pay £4 but that was deemed to expensive).

I'm impressed that you get to see your doctor every months. I'm lucky if I get to see mine every 6 months. In fact, I sent her a letter once and it was returned from the hospital two months later as being with a note that the department didn't exist (despite using the address as printed on their letterhead!).

I guess that's the tradeoffs, lower cost but I hardly get to see anyone. Mind, I don't think they have any more ideas for treatments for me so there's not much point.

It is a bit difficult when they put you in the position that if you miss anything in any way you're out. We do have that in common. AS far as getting your doctor to talk, I had that issue as well. I simply said to mine that I nneded her to tell me exactly what's going on so that I could be informed enough to be able to manage things better on my own. It seemed to help when I told her that I was trying to embrace salf-management.

Hopefully there's something useful in all that.

fim

Hi fim,

I guess there is no perfect answer with health care. I always wish I could be somewhere that the costs weren't so high. It's actually not great news that I "get" to see my doctor every month. It's that I show up every month when I am told to and I am on time or else I will not have any medication that month. Period and NO excuses. So, it's almost more of a constant threat than any kind of blessing. And, the appointments are very expensive and very brief. I learn nothing and nothing is even mentioned to give me any hope of every feeling any better than I do right now which is just terrible. So, I honestly would prefer not to have to jump through the hoops that are required of me just to have medication that I feel like I need to stay alive. If it was a doctor who acted interested, it might be different. But, no.

Mal, if you see this, know that you have a huge blessing with that kind of medical care where you are! I would LOVE to come but reality doesn't allow me to! Whenever you have to wait for a bit in a waiting room remember that you get great care and it's worth it!

gail

Mal....I have to ask you.... who are your doctors???? I live in Fl also... and I have some real doubts about the doctors here.... I have been to a lot of them here.... so.... please.... fill me in......... I also have BCBS.... Where about in Southwest Fl...are you talking about......

Craig