Double-checking EOBs

Provider: Dr. X
Date: 3/15/11
Service: Computed tomography
Charge: $753
Allowed: $243
Paid: $194.40
Patient Responsibility: $48.60

Very curious.

  • I haven’t seen Dr. X since January.
  • Dr. X doesn’t do any imaging in his office; he refers people to an outside facility.
  • This test was not done.  Not there nor anywhere else.

I wonder if someone in the billing office made multiple typos (wrong patient, wrong procedure), or if there’s some fraud going on.  I really hope it was an honest error and they get it fixed without a huge time investment on my part.

Non-Compliant?

For the first time in my life, I chose not to get testing done that a doctor recommended.  I thought about it, blogged about it, thought some more, and decided not to do it.

When I phoned to cancel the appointment, the scheduler tried to talk me out of it, stressing the importance of a test that the doctor had ordered.  She was good, too, and convinced me that I should just re-schedule.  I thought about it some more, then the day before the rescheduled test, I phoned to cancel.  No, don’t reschedule.  Just cancel it.

Next, I cancelled my follow-up appointment with the doctor who ordered the CT.  That receptionist, too, offered to reschedule me.  When I declined, she asked for my reason for cancelling.  The whole point of the appointment was to look at the films and discuss the radiologist’s report.  No test means no need for follow-up.

Today’s mail brought a letter from the doctor.  Sitting at the post office, holding the mail, I wondered if opening the envelope was going to reveal a letter saying that if I wasn’t going to get the test he recommended, there was no need for me to ever return.  I was pleasantly surprised:

Wow!  What a nice letter.  It almost tempts me to reschedule the test.  Almost.  My cynical side says that this would be fabulous as CYA defense, in the highly unlikely event that this is somethings serious leading to death and my survivors wanted to sue; so maybe it’s not concern for me, but himself, that prompted the letter.  Yep, I can be pretty cynical!  I’d rather think it’s just a really nice letter and the doctor is a really nice person.

Tired as I am of not being 100% healthy, I didn’t arbitrarily blow-off the CT.

  • Symptoms were reduced.  Not completely gone, but mostly.  Way better than when I first saw my PCP
  • I have a life, and I don’t want to sacrifice more time to medical issues.  Occupation:  patient
  • I don’t need more exposure to radiation
  • So long as the symptoms are tolerable, I’m okay with not being positive of the cause (for now)
  • The test is expen$ive

About that last one:  So far this year, my insurance company has already processed $5,957.97 in claims for my family.   Insurance has picked up most of it; nonetheless, our out-of-pocket in January was $1,300.96.  We’ve already spent another $60 this month, plus have two appointments this week that will set us back roughly $200 each.  You see why I’m reluctant to incur the expense of a CT scan which will be entirely out-of-pocket.  If the symptoms were still bothering me, I’d spend the money; it’s hard to fork out that kind of money when the symptoms are nearly gone.

Dr. ENT, thank you.  I’m impressed that you’d take the time to write such a nice letter when you didn’t really have to contact me at all.    If the symptoms get worse again, I’ll be sure to investigate.

Radiation Risks

With all the talk about the accumulation of medical radiation being a cancer risk, I sometimes wonder about all the x-rays taken to assess RA progression.  An initial appointment with a rheumatologist usually includes base-line x-rays.  Additional x-rays are taken routinely every couple years, plus extras whenever something concerning occurs.

Someone commented to me the other day that I should be worried that all those x-rays I’ve gotten might cause cancer.  My response was that if the people with medical training aren’t worried about it, why should I be?!

I wondered how much risk there really is, and discovered a great way to find out.  There’s a website with a radiation risk calculator.  Compile a list of all the x-rays, CT scans, fluoroscopy (barium swallows), nuclear medicine studies, and angiograms that you’ve had over the years, enter all the exams into the risk calculator, and your results will easily display.

Cool tool!