Guest guest Posted May 19, 2004 Report Share Posted May 19, 2004 Billing practices... I'm a medical biller and you just caught my attention, would you care to elaborate at all? [ ] New doctor--Experience w/ PLAQUENIL or CELLCEPT? > I am searching for a new rheumatologist in the Houston (Spring Branch) area. > I have lost faith in my current doctor because of his billing practices. > Does anyone have a really good doctor in this area? I really don't like to > doctor hop and have heard of folks who have had to do this to find a good > one. I hope that you all can help me. > > I am currently taking Enbrel and have had marvelous results; except for my > hands. My current doctor just put me on three (3) injections a week. > Quite frankly, I'm scared, considering possible side affects. Has anyone > else had experiences with 3 injections/week or is this excessive? I know > it's expensive and my insurance will only pay for 2 injections/week. Please > give me some feedback. He's also suggested plaquenil or cellcept. Any > experience with either of these? > > > [Editor's Note: I think it fair to say your doc is taking an aggressive approach--one which you evaluate as having " had marvelous results; except for my hands. " Are your hands the reason to up the ante on Enbrel & add an immunomodulator? If you are going to make a doctor change, it's probably best not to make any changes until you see your new doc, especially when dealing with such an aggressive medication regime. Also: You probably want to make one change--more Enbrel OR Plaquenil/Cellcept (how about methotrexate? It's the most successful of the immunomodulators), not both at once--to which would you attribute any changes? > D.] > > _________________________________________________________________ > FREE pop-up blocking with the new MSN Toolbar - get it now! > http://toolbar.msn.click-url.com/go/onm00200415ave/direct/01/ > > > > > Please visit our Psoriatic Arthritis Group's informational web page at: > http://www.wpunj.edu/pa/ -- created and edited by list member aka(raharris@...). > > Also,in August 2001,list member Jack aka Cornishpro@... began to conduct extensive research which he publishes as the " Psoriatic Arthritis Research Newsletter " , monthly in our email and digest format. Many thanks to Jack. Back issues of the newsletter are stored on our PA webpage as well as the archives of the list. > > Don't forget that the list archives comprise a tremendous amount of information (Over three years of messages and answers).Feel free to browse them at your convenience. > > LET'S HEAR FROM SOME OF YOU LURKERS out there! If you have a comment or question, chances are there is a person who has been around a while who can help you out with AT LEAST an educated guess for an answer! If not,we can steer you in the right direction with a good website to go to, > > Blessings and Peace, > > Atwood-Stack, Founder > Alan , Web & List Editor > Jack , Newsletter Editor > Pat Bias, List Editor > Ron Dotson, List Editor > Orin, List Editor > , List Editor > and any others who help in any way (thank you!) > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 19, 2004 Report Share Posted May 19, 2004 I live in Katy and my Dr. is in The Woodlands. Her name is Carmen -Mauselli. I really like her but I also know there has been at least one complaint against her on the site. I know the Drs. at UT- Houston are very good as well. One of the Drs. from there is joining Dr. in June. I tried Enbrel but didn't have success with it. I am trying Remicade now and so far it is working great. Debbie > I am searching for a new rheumatologist in the Houston (Spring Branch) area. > I have lost faith in my current doctor because of his billing practices. > Does anyone have a really good doctor in this area? I really don't like to > doctor hop and have heard of folks who have had to do this to find a good > one. I hope that you all can help me. > > I am currently taking Enbrel and have had marvelous results; except for my > hands. My current doctor just put me on three (3) injections a week. > Quite frankly, I'm scared, considering possible side affects. Has anyone > else had experiences with 3 injections/week or is this excessive? I know > it's expensive and my insurance will only pay for 2 injections/week. Please > give me some feedback. He's also suggested plaquenil or cellcept. Any > experience with either of these? > > > [Editor's Note: I think it fair to say your doc is taking an aggressive approach--one which you evaluate as having " had marvelous results; except for my hands. " Are your hands the reason to up the ante on Enbrel & add an immunomodulator? If you are going to make a doctor change, it's probably best not to make any changes until you see your new doc, especially when dealing with such an aggressive medication regime. Also: You probably want to make one change--more Enbrel OR Plaquenil/Cellcept (how about methotrexate? It's the most successful of the immunomodulators), not both at once--to which would you attribute any changes? > D.] > > _________________________________________________________________ > FREE pop-up blocking with the new MSN Toolbar – get it now! > http://toolbar.msn.click-url.com/go/onm00200415ave/direct/01/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2004 Report Share Posted May 20, 2004 I was being charged for home health care when I was receiving none. His office told me that because I was on enbrel and he was monitoring me that he had a right to charge this even though he never once called or in any other way contacted me other than the times when I was in his office. I challenged it with his office managed and she conceded by reversing 2 of the 3 month's charges ($200 a month) but she stated that the other charge would stand. Of course, none of them are founded in my opinion. I spoke with my health insurance folks and they are investigating. Insurance costs too high to deal with someone who possibly is involved in this kind of activity. So now I am looking for a new doctor who I can trust. How can I trust his treatment if I cannot trust his ethics. L [Editor's Note: Even if your doc's billing IS permissible in certain circumstances (and it would surprise me of it was), I absolutely agree with you. That is pretty darn slimy, and I think your last sentence sums things up perfectly. D.] >From: " Boyd " <celticangyl@...> >Reply- >< > >Subject: Re: [ ] New doctor--Experience w/ PLAQUENIL or >CELLCEPT? >Date: Wed, 19 May 2004 19:28:03 -0400 > >Billing practices... I'm a medical biller and you just caught my attention, >would you care to elaborate at all? > > [ ] New doctor--Experience w/ PLAQUENIL or >CELLCEPT? > > > > I am searching for a new rheumatologist in the Houston (Spring Branch) >area. > > I have lost faith in my current doctor because of his billing >practices. > > Does anyone have a really good doctor in this area? I really don't like >to > > doctor hop and have heard of folks who have had to do this to find a >good > > one. I hope that you all can help me. > > > > I am currently taking Enbrel and have had marvelous results; except for >my > > hands. My current doctor just put me on three (3) injections a week. > > Quite frankly, I'm scared, considering possible side affects. Has >anyone > > else had experiences with 3 injections/week or is this excessive? I >know > > it's expensive and my insurance will only pay for 2 injections/week. >Please > > give me some feedback. He's also suggested plaquenil or cellcept. Any > > experience with either of these? > > > > > > [Editor's Note: I think it fair to say your doc is taking an aggressive >approach--one which you evaluate as having " had marvelous results; except >for my hands. " Are your hands the reason to up the ante on Enbrel & add an >immunomodulator? If you are going to make a doctor change, it's probably >best not to make any changes until you see your new doc, especially when >dealing with such an aggressive medication regime. Also: You probably want >to make one change--more Enbrel OR Plaquenil/Cellcept (how about >methotrexate? It's the most successful of the immunomodulators), not both >at >once--to which would you attribute any changes? > > D.] > > > > _________________________________________________________________ > > FREE pop-up blocking with the new MSN Toolbar - get it now! > > http://toolbar.msn.click-url.com/go/onm00200415ave/direct/01/ > > > > > > > > > > Please visit our Psoriatic Arthritis Group's informational web page at: > > http://www.wpunj.edu/pa/ -- created and edited by list member > aka(raharris@...). > > > > Also,in August 2001,list member Jack aka Cornishpro@... >began >to conduct extensive research which he publishes as the " Psoriatic >Arthritis >Research Newsletter " , monthly in our email and digest format. Many thanks >to >Jack. Back issues of the newsletter are stored on our PA webpage as well as >the archives of the list. > > > > Don't forget that the list archives comprise a tremendous amount of >information (Over three years of messages and answers).Feel free to browse >them at your convenience. > > > > LET'S HEAR FROM SOME OF YOU LURKERS out there! If you have a comment or >question, chances are there is a person who has been around a while who can >help you out with AT LEAST an educated guess for an answer! If not,we can >steer you in the right direction with a good website to go to, > > > > Blessings and Peace, > > > > Atwood-Stack, Founder > > Alan , Web & List Editor > > Jack , Newsletter Editor > > Pat Bias, List Editor > > Ron Dotson, List Editor > > Orin, List Editor > > , List Editor > > and any others who help in any way (thank you!) > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2004 Report Share Posted May 20, 2004 Uhm, he can't do that at all! That is insurance fraud. I've been doing this now for about 3 yrs, and he can't get away with it, not even one month's supply. He is monitoring your meds, granted, but when you are in his office... unless he or someone else personally came to your home. I am glad you contacted the insurance company and filed a complaint. He could lose his insurance contract, and once he loses one, his credentialling process could be jeopardized, and might lose others! I'm glad you took a stand, alot of people don't! Mel [ ] New doctor--Experience w/ PLAQUENIL or > >CELLCEPT? > > > > > > > I am searching for a new rheumatologist in the Houston (Spring Branch) > >area. > > > I have lost faith in my current doctor because of his billing > >practices. > > > Does anyone have a really good doctor in this area? I really don't like > >to > > > doctor hop and have heard of folks who have had to do this to find a > >good > > > one. I hope that you all can help me. > > > > > > I am currently taking Enbrel and have had marvelous results; except for > >my > > > hands. My current doctor just put me on three (3) injections a week. > > > Quite frankly, I'm scared, considering possible side affects. Has > >anyone > > > else had experiences with 3 injections/week or is this excessive? I > >know > > > it's expensive and my insurance will only pay for 2 injections/week. > >Please > > > give me some feedback. He's also suggested plaquenil or cellcept. Any > > > experience with either of these? > > > > > > > > > [Editor's Note: I think it fair to say your doc is taking an aggressive > >approach--one which you evaluate as having " had marvelous results; except > >for my hands. " Are your hands the reason to up the ante on Enbrel & add an > >immunomodulator? If you are going to make a doctor change, it's probably > >best not to make any changes until you see your new doc, especially when > >dealing with such an aggressive medication regime. Also: You probably want > >to make one change--more Enbrel OR Plaquenil/Cellcept (how about > >methotrexate? It's the most successful of the immunomodulators), not both > >at > >once--to which would you attribute any changes? > > > D.] > > > > > > _________________________________________________________________ > > > FREE pop-up blocking with the new MSN Toolbar - get it now! > > > http://toolbar.msn.click-url.com/go/onm00200415ave/direct/01/ > > > > > > > > > > > > > > > Please visit our Psoriatic Arthritis Group's informational web page at: > > > http://www.wpunj.edu/pa/ -- created and edited by list member > > aka(raharris@...). > > > > > > Also,in August 2001,list member Jack aka Cornishpro@... > >began > >to conduct extensive research which he publishes as the " Psoriatic > >Arthritis > >Research Newsletter " , monthly in our email and digest format. Many thanks > >to > >Jack. Back issues of the newsletter are stored on our PA webpage as well as > >the archives of the list. > > > > > > Don't forget that the list archives comprise a tremendous amount of > >information (Over three years of messages and answers).Feel free to browse > >them at your convenience. > > > > > > LET'S HEAR FROM SOME OF YOU LURKERS out there! If you have a comment or > >question, chances are there is a person who has been around a while who can > >help you out with AT LEAST an educated guess for an answer! If not,we can > >steer you in the right direction with a good website to go to, > > > > > > Blessings and Peace, > > > > > > Atwood-Stack, Founder > > > Alan , Web & List Editor > > > Jack , Newsletter Editor > > > Pat Bias, List Editor > > > Ron Dotson, List Editor > > > Orin, List Editor > > > , List Editor > > > and any others who help in any way (thank you!) > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2004 Report Share Posted May 20, 2004 Thanks for the encouragement. Now I have another question--perhaps you can help. I know you are active on the site. The last few days I've been having a lot of tingling in my hands and feet, and my hands going to sleep. Now my toes on one foot are cramping so badly that the toes don't line up. My feet, legs, and hands are also cramping, but not as severly. I'm getting frightened. Could it be the enbrel? I am so tired. I thought it was just the end of school (I'm a teacher--now just working half time, tho), but this is more. Who can I turn to? Obviously not my rheumatologist! [Editor's Note: You should consult your doc. Hands & feet tingling, and going to sleep, is in all likelihood neurologic stimulation and aggravation; the cramping is muscular; both are secondary to the disease activity, quite possibly resulting from vasculitis (inflammation of the blood vessels) induced by PA, RA, SLE, etc. Although there is much more to know about Enbrel and other biologics, it's unlikely it's the culprit. D.] >From: " Boyd " <celticangyl@...> >Reply- >< > >Subject: Re: [ ] New doctor--Experience w/ PLAQUENIL or >CELLCEPT? >Date: Thu, 20 May 2004 21:43:33 -0400 > >Uhm, he can't do that at all! That is insurance fraud. I've been doing >this now for about 3 yrs, and he can't get away with it, not even one >month's supply. He is monitoring your meds, granted, but when you are in >his office... unless he or someone else personally came to your home. I am >glad you contacted the insurance company and filed a complaint. He could >lose his insurance contract, and once he loses one, his credentialling >process could be jeopardized, and might lose others! I'm glad you took a >stand, alot of people don't! > >Mel > > [ ] New doctor--Experience w/ PLAQUENIL or > > >CELLCEPT? > > > > > > > > > > I am searching for a new rheumatologist in the Houston (Spring >Branch) > > >area. > > > > I have lost faith in my current doctor because of his billing > > >practices. > > > > Does anyone have a really good doctor in this area? I really don't >like > > >to > > > > doctor hop and have heard of folks who have had to do this to find a > > >good > > > > one. I hope that you all can help me. > > > > > > > > I am currently taking Enbrel and have had marvelous results; except >for > > >my > > > > hands. My current doctor just put me on three (3) injections a >week. > > > > Quite frankly, I'm scared, considering possible side affects. Has > > >anyone > > > > else had experiences with 3 injections/week or is this excessive? I > > >know > > > > it's expensive and my insurance will only pay for 2 injections/week. > > >Please > > > > give me some feedback. He's also suggested plaquenil or cellcept. >Any > > > > experience with either of these? > > > > > > > > > > > > [Editor's Note: I think it fair to say your doc is taking an >aggressive > > >approach--one which you evaluate as having " had marvelous results; >except > > >for my hands. " Are your hands the reason to up the ante on Enbrel & add >an > > >immunomodulator? If you are going to make a doctor change, it's >probably > > >best not to make any changes until you see your new doc, especially >when > > >dealing with such an aggressive medication regime. Also: You probably >want > > >to make one change--more Enbrel OR Plaquenil/Cellcept (how about > > >methotrexate? It's the most successful of the immunomodulators), not >both > > >at > > >once--to which would you attribute any changes? > > > > D.] > > > > > > > > _________________________________________________________________ > > > > FREE pop-up blocking with the new MSN Toolbar - get it now! > > > > http://toolbar.msn.click-url.com/go/onm00200415ave/direct/01/ > > > > > > > > > > > > > > > > > > > > Please visit our Psoriatic Arthritis Group's informational web page >at: > > > > http://www.wpunj.edu/pa/ -- created and edited by list member > > > aka(raharris@...). > > > > > > > > Also,in August 2001,list member Jack aka Cornishpro@... > > >began > > >to conduct extensive research which he publishes as the " Psoriatic > > >Arthritis > > >Research Newsletter " , monthly in our email and digest format. Many >thanks > > >to > > >Jack. Back issues of the newsletter are stored on our PA webpage as >well >as > > >the archives of the list. > > > > > > > > Don't forget that the list archives comprise a tremendous amount of > > >information (Over three years of messages and answers).Feel free to >browse > > >them at your convenience. > > > > > > > > LET'S HEAR FROM SOME OF YOU LURKERS out there! If you have a comment >or > > >question, chances are there is a person who has been around a while who >can > > >help you out with AT LEAST an educated guess for an answer! If not,we >can > > >steer you in the right direction with a good website to go to, > > > > > > > > Blessings and Peace, > > > > > > > > Atwood-Stack, Founder > > > > Alan , Web & List Editor > > > > Jack , Newsletter Editor > > > > Pat Bias, List Editor > > > > Ron Dotson, List Editor > > > > Orin, List Editor > > > > , List Editor > > > > and any others who help in any way (thank you!) > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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