Medicare not paying for doctor's errors

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FitzyK23
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Date Joined May 2005
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   Posted 2/20/2008 3:44 PM (GMT -7)   
Sarita- they talk about cath issues too!!!
 
 
26 Year old married female.  Diagnosed w/ CD 3 years ago, IBS for over 10 years before that, which was probably the CD.  Currently on Pentasa 4 pills/4x day, hysociamine prn, nexium, and ortho evra.  Good times!!!
 
 


njmom
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Date Joined Apr 2006
Total Posts : 1884
   Posted 2/20/2008 6:23 PM (GMT -7)   
Interesting. Thanks.
Daughter (20) Dx'd Crohn's 3/06. Misdiagnosed for two years, including by top pediatric Crohn's specialist as stress and needing more fiber but landed in hospital in 3/06 with cramps, vomiting, stricture. Now in remission with Entocort 3 mg (one pill), SCD multivit, yogurt, vit D3 1800IU, 900+ mg calcium, 50 mg B complex vit, 25 mg iron. Off SCD diet but wheat was iffy so back on SCD modified to include potatos and rice.   


broomhilda
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Date Joined May 2007
Total Posts : 1488
   Posted 2/20/2008 9:27 PM (GMT -7)   
Fitzy-It's nice to know insurance companies are doing SOMETHING positive for the patient. I think they should have rejected payment to my hospital for the last week of my stay during my resection.
Because I contracted a lovely staff infection while I was there trying with every ounce of immune strength I had left to survive! I also think the insurance companies should refuse to pay for wrong diagnosis in the ER! Such as my recent gall bladder duct blockage caused by a stone. The only thing they could find on my CT scan (which was run without dye) was an ovarian cyst. Hmmmm, how is it I had severe pain under my rib cage and vomiting and no lower quadrant pain? Also, why did they immediately dose me full of morphine and then ask me if I felt any pain just prior to release from the ER! MAJOR DUH! I would have ripped someones head off over your cath issues! Sorry to sound violent, but sometimes the squeaky wheel gets the oil!
Dx'd Jan'06, 1st Resection 7/06, Predinsone, Humira, Imuran, B12 injections, Nexium. Secondary conditions: Psorasis, Acne, Fatigue, Joint Pain, Lactose Intolerant, gallstones, fibroid cysts, peri-menopausal.


FitzyK23
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Date Joined May 2005
Total Posts : 4219
   Posted 2/20/2008 10:16 PM (GMT -7)   
I didn't have cath issues. Luckily I never had one. It was Sarita that did but I am guessing that is who you were referring to. I just hope that those lost costs don't all get passed on to the uninsured.
26 Year old married female.  Diagnosed w/ CD 3 years ago, IBS for over 10 years before that, which was probably the CD.  Currently on Pentasa 4 pills/4x day, hysociamine prn, nexium, and ortho evra.  Good times!!!
 
 


tinglebell
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Date Joined Apr 2007
Total Posts : 531
   Posted 2/20/2008 10:23 PM (GMT -7)   
As an RN, I have always felt that a person should be on an antibiotic for 2 days after a catheter, just for precaution. I can't tell you how many folks I saw in the ER following hospitalization with a UTI post cath.
DIANNE
Humira, pred and entocort 1/08
3 small bowel resections, 1 for perforation, 2 for strictures 
 


map lady
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Date Joined Feb 2008
Total Posts : 154
   Posted 2/20/2008 10:52 PM (GMT -7)   
FitzyK23 said...
 I just hope that those lost costs don't all get passed on to the uninsured.

They will.  Hospitals claim they need their ridiculous 200%-300% profit margins (insured people pay about 30% profits in comparison) to offset the cost of treating the uninsured and covering their malpractice insurance.  They use any additional reason available to drive up their prices and profits, which in turn drives up all of our insurance premiums and, ironically, makes even more people end up being uninsured.  If people weren't getting charged so much extra unnecessary money for hospital treatment many more people would be able to afford to actually pay the hospital instead of file for bankruptcy, and the hospitals wouldn't have to cry about how much money they "lose" from uninsured patients not paying.
 
I was otherwise very glad to read that insurance carriers aren't going to pay for illnesses and injuries that are the fault of the hospital.  Maybe it'll at least motivate more hospitals to do a better job of dispensing the correct medications and not leaving items inside people and not giving everyone a catheter "just in case" and so on ;)

Sarita
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Date Joined Mar 2005
Total Posts : 2486
   Posted 2/20/2008 11:39 PM (GMT -7)   
Tingle, I bet in many ways that would be a good idea...I myself got a 3-day course of Cipro the day after I was released from the hospital because I figured the blatantly miscalculated insertion of my Foley would result in a UTI. Although I am always an alarmist about antibiotic resistance so avoid the anti-b's whenever possible...

It'll be a long process to eliminate needless catheterizations...starting with the hospital administrators and proceeding onto the chief of medicine, the attendings, the residents, the interns, the nurses, the LPNs, the medical assistants...but heck, that alone would save billions of dollars for the healthcare industry. A little prevention goes a long way.

Thanks for posting the link, Fitz.
Co-moderator - IBS Forum


teddybearweiser
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Date Joined Oct 2004
Total Posts : 3042
   Posted 2/21/2008 3:19 AM (GMT -7)   
Hi I read the artical it was very intresting.
Hi, I am teddybearweiser, I am a male.
I was diagnosed with crohns disease when i was admitted to the hospital
in 1992, in Jan of 1993 I was back in the hospital for surgery for my crohns. I had part of my right colon resectioned with ilecolonstomy.
 My GI doctor has me on Asacol, Dicyclomine,Imuran,Celebrex and Remicade. B-12 injection once a month.
My Internest doctor has me on Lisnopril-HTCZ and Folic Acid. Diagnosed
with Osteoarthritis July 2007
 


HabsHockeyFan
Veteran Member


Date Joined Jan 2006
Total Posts : 3130
   Posted 2/21/2008 8:30 AM (GMT -7)   
Well...I work in the reinsurance industry and I rate based on experience. This should help some of the Medicare plans I see save experience costs and therefore save on reinsurance costs. the health plans can then help pass on this savings to their members. It's funny, but people are finally starting to see that facilities are part of the big costs they pay not just the insurance comapnies.
Remember insurance consumers....check your bills from hospitals and doctors just like you look at your charge card bills. Humans generate the bills and people in charge of profits determine costs. You can find errors and misbillings and report them to your insurance company. Some insurance plans even reward members for finding errors that save the insurance company money. If you feel something was misbilled or there was a complication that you feel should be the hospitals cost, use your insurance comapny as a partner to avoid the billing even if you are not on Medicare. Yes, the facility may pass this on to other consumers, but the process has to start somewhere.
Dx'd '90 (emergency rupture), symptoms ignored long before that, '03 fistulas and bad flagyl reactions, B12 weekly, Pentasa [until I surrender to the bigger meds]
I'm riding on the escalator of life....


broomhilda
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Date Joined May 2007
Total Posts : 1488
   Posted 2/22/2008 7:33 PM (GMT -7)   
Tingle, that is a great idea. Come to think of it my urologist ALWAYS gives me a single dose of Levaquin after every invasive exam or minor procedure. Strangely enough I've never been one who has a lot of UTI's in the first place. You would think I would be since my ureter likes to get choked from inflammation every now and then.
Dx'd Jan'06, 1st Resection 7/06, Predinsone, Humira, Imuran, B12 injections, Nexium. Secondary conditions: Psorasis, Acne, Fatigue, Joint Pain, Lactose Intolerant, gallstones, fibroid cysts, peri-menopausal.

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