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Having worked for a hand surgeon who deals with WC and a MT..this is what I know.

Posted By: MT/biller on 2008-07-26
In Reply to: does workman's compensation cover us for carpal tunnel? nm - anon

The poster below me, Just Me, is pretty correct.  A lot of our patients filed worker's compensation, but because there are a lot of things you do with your hands in your personal life, it is a diffcult situation to prove.  For instance, we had one lady who was an MT for a few years but was also an avid quilter..she lost her case. We have had people who say have worked for the hospital as an MT for 13 and had no other real side hobbies or jobs outside of that that won her case. They only have so long to approve or disapprove your claim. From what I have seen, anyone who has worked multiple jobs at that same time are not going to win the case because the employer you filed on will fight you and tell them that you were working multiple jobs so how do they know that it was your job with them that is solely responsible. So, depending on your circumstance, employer (you do have to file a claim on an employer whom you will name), you could get worker's compensation which would pay for surgery if needed, PT, and time loss benefits after surgery.  The first step is filing a notice of injury with your employer and then they submit it to their worker's compensation carrier.  I was the hand surgeon's worker's compensation biller so I speak the truth LOL. If you have anymore questions or what to share you personal story and get my honest opinion, I'm here. I've seen every kind of WC claim you can imagine. Most people are honest but some are not and WC is the first one to nail you. They have even had a private investigator follow people.  We had one carpal tunnel WC patient who stated he couldnt work because he was in such pain yet he was videotaped making an extensive bird sanctuary, actually building it with his bare hands.. Can you say busted.. I knew you could.


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I worked for a plastic surgeon for 3 months...sm
and people having face lifts and tummy tucks are in incredible pain after their surgical procedure. My sister chose to have breast implants done and she was in severe pain for about 3 days after surgery. No way am I interested in having elective things like this done!
I used Short Keys, not Short hand for Bayscribe, it worked fine.
x
The deals were great...
I got the Kodak EasyShare 6 megapixel camera for $200, and I got my daughter a flat screen 20-inch TV with DVD player for $100.  Can't beat that.  I always go to Wal-Mart.  They guarantee prices, so I gather up all the sale ads the night before and just get it all done there.  I love black Friday :)
Any good laptop deals around?
Im looking for a laptop with wireless so that I can be mobile, any suggestions?
Does anyone know of a website, like this one, that deals with Medical Coding/Billing..sm

My husband is curious and wanting to get into Medical Billing/Coding and work from home like I do with transcription.  Does anyone know of a website, like this one, that offers so many jobs from home and information regarding coding and/or billing?  Thanks.  Also, if anyone has input on this please let us know.  Would love to find out which course is the best, etc....thanks!


I've used Hand-Eze and Thergonomic Hand Aids. sm
They help with the carpal tunnel and keep hands warm for me. They cover the hand and wrist but leave the fingers free. I wear them inside out, though, because the seams rub on the skin too much for me. I've gotten so used to them, that it is more comfortable wearing them while typing than typing with nothing on.
Don't talk about hand, I still remember the one that got her hand chewed up by her pet rat....

had nightmares for 2 days after that.



Well, if you broke your right hand and were right-hand dominant, can you see how this might be a fac
It may not be relevant at the time of dictating a physical exam or social history but in the future it would be good to know if the patient breaks the finger(s), wrist, hand, arm.
I just had a surgeon ask...
his PA if there was such a breast size as F, get an affirmative, and then say, "so she's a double FF?  She has the largest breasts I've ever seen". It made me laugh out loud, I don't know why, maybe it was his tone of disbelief or that fact that he's been around a long time and has surely seen many boobs in his day...thought I'd pass it along.
One surgeon I know always says...

when a patient is ready to be discharged, he always says "____ is peeing and pooping normally."  Slays me every time!  I just find myself giggling like a little kid whenever I hear it!  Peeing and pooping are such a great words...embrace them!    


Isn't there a book out there called "Everybody poops?" 



 


I have not seen a surgeon yet.

I want to get my finances ready before I schedule the surgery.  My previous experience with surgeons and disability is "go back whenever you feel ready"...they don't seem to want to comit to a timeline.  The last time I had surgery I went back way too soon and had complications, so would like to avoid that this time around. 


Thanks to everyone who has replied, this is all good advice and info.  I think I will plan for the worst at 6 weeks or so and hope for best at just a week or two.  It certaily won't hurt to have some extra money saved. 


One surgeon
I transcribe for has many times told them to pipe down in the background. I am not sure if it is because he cannot think with the noise or if he is doing it for my benefit, but either way, I appreciate it.

On the other hand, I had an Indian doctor the other day who sang/chanted his entire report. If you have ever been to a Catholic mass and have heard the priest do that singsong kind of thing, well that is how he dictated his entire report. Every now and then he would hold the note a little longer. It was the weirdest thing.
oral surgeon...

I had a similar situation a few years ago.  I paid and the ins. co. paid, dentist kept both payments.  After 3 phone calls to the office, no money.  So, I wrote a letter to the dentist, put PERSONAL AND CONFIDENTIAL on the envelope, put a cc to the state dept of insurance at the bottom of the letter (dept of ins. scares them more than the AMA (if dealing with MDs) or American Dental Association). 


Got my money 2 days later.


checking out a surgeon?
is there a way to check out a surgeon or doctor before making an apt with them?  (complaints, track record or anthing else).  I've never been comfortable with the "referral" from your primary or whoever it might be because I can't shake the idea of friends referring to friends and not based on qualifications.  thanks
need a plastic surgeon
Does anyone have any personal experience with Dr. Michael Petrosky with Plastic Surgery Center of the South in Marietta, Georgia?  I am considering using him as I consulted with him and I really liked his manner and explanation of the surgery.  I would like to talk with someone who has used him before just to see if he is a good doctor, but how can one go about doing that with the HIPPA laws?  The only way I know to find out about patients of his is to ask their office and of course they aren't going to give me names/phone numbers.  If anyone has any info on this doctor's practice would you mind sharing with me please?  Or if you know of a way that I can talk to a few people who have used him, etc.  Thanks very much.
Went to an oral surgeon for a consult for

my son to have his wisdom teeth removed.  Charged us $75.00 for the consult.  I didn't like the oral surgeon and his office staff were very standoffish can I did not make an appointment with him for surgery, but with another oral surgeon.   I had to pay the $75.00 up front - no problem, but they filed the insurance with the money coming to them.  It has been 5 weeks now since they received payment and I have called twice asking for a refund.  They told me the insurance company had 90 days to come back and ask for the money, but I PAID upfront so what difference does that make, they aren't out anything and they have $52.00 of MY money on top of the $75.00.   They said they would issue a check next week, but is what they told me 2 weeks ago.  It isn't a lot of money, it is the principle of the thing.


Went to another oral surgeon and they didn't charge me anything for the consult and the amount I have to pay upfront is $300.00 less than what the other office quoted me.  


 


Seeing an oral surgeon is very premature! nm
nm
ASR funny. The surgeon has just done a robotic....sm
radical prostatectomy and signing off he says "Please send a copy to Dr. John Doe and to the prostate, and to the chart. End of dictation".
I think the difference here is surgeon quality
and also patient demographics.

Be sure you are seeing a top cataract surgeon who is doing 6-8 a day and has satisfied patients. Do not wait until you're 90 to see an ophthalmologist. Those patients do tend to have problems with surgery.


I made an appointment with an oral surgeon and he
You have to start at the very bottom and be as conservative as you can.  A dentist can take x-rays and fit you with an appliance.  I went and found out whats causing my jaw pain and on the x-ray my bones overlap.  I was thinking I needed surgery, but we are going with pain management.  Since i've had the appliance, no pain, that was a week ago.  Very rarely will you need surgery, everyone's jaw "clicks" but if you are a night grinder, this makes it an even playing field for your teeth so they're not fighting against the jaw to become "even" if that makes sense.  Good luck.
I transcribe for orthopedic surgeon who utilizes EMR
He dictates notes such as if the patient is having out of hte ordinary symptoms to cover himself should the situation lead to a court room setting. But, yes, between EMR and voice recognition, I believe MTs will over time be less than necessary.

The cost is a major factor. Especially with the population aging like we are. Baby boomers will all be on SS at same time and if health care doesn't figure something out, there are predictions being made that are nightmarish, like the collapse of the health care system. This was said by a person (Dr. Andrew Weil) being interviewed by Larry King.


I do work for a plastic surgeon, insurance will only pay from what I can tell IF - sm
there is a health issue, i.e. continous rash from the folded skin, irritation that medicine will not resolve. But all conservative measures of treating have to be exhausted before they agree to pay for an abdominoplasty. Good luck....I need to lose about 80 pounds and wondering if I will have any sag when done...I have very sensitive skin too so expect some problems (and if so I hope they are enough to warrant my insurance to pay for the removal procedure...otherwise I plan to save up for it)--
Well, well, well. Found this blog written by a surgeon sm

who says what he REALLY thinks about the JCAHO. Funny, I found it on Google when I typed in JCAHO and q.i.d. since I wasn't sure what to do about q.i.d. ........


 


The Death Star of American Medicine




I wish I had written this (JCAHO Unplugged; registration required), because it gives voice to the feelings that I (and probably 99% of the physicians in this country) have about the Death Star of American medicine -- JCAHO. A few excerpts (emphasis is mine):

That is why it really upsets me to watch the JCAHO people walk through my hospital like they were navigating a toxic waste dump. What upsets me even more is the utter paralysis of normal activity that occurs months before their visit and the huge sums of money spent on mock drills and consultants to prepare for the JCAHO invasion. JCAHO (the Joint Commission on Accreditation of Healthcare Organization) arouses more fear in hospitals than MRSA gone wild, and their "visit" has a greater institutional paralytic effect than circulating a neuromuscular depolarizing agent through the ventilation system.

A few unsigned verbal orders, or an anesthesiologist carrying a syringe of Anectine in his or her scrubs, or not locking up I.V. bottles of normal saline will result in conditional or provisional approval, and failure to take remedial action within 30 days may result in the death penalty, which for the hospital means bad PR, and more significantly, loss of all federal money. That's right, you can get the chair for parking tickets in the JCAHO world.

It doesn't matter that the hospital admits 50,000 patients a year, saves countless lives and performs daily miracles. Write q.i.d. twice and you can get your liver transplant someplace else.
"A response by Russell Massaro, MD, FACP, Executive Vice President Accreditation and Certification Operations, JCAHO, follows Dr. Cossman's screed. The only thing I can say about it is that he makes clear that unannounced surveys will be forthcoming in 2006. Oh, joy!

A lot of the press in the past few days has been discussing issues such as oversight, accountability, and clearly expressed legal authority. JCAHO operates without any real semblence of these niceties, and does so with all the subtlety of a bureaucracy run by Darth Vader. Watching hospital administrators lose bowel and bladder control the minute a JCAHO inspection is brought up has always reminded me of Vader's underlings wilting in his presence --- and for good reason. Without the JCAHO seal of approval, they cannot operate an otherwise well-run, caring facility. The organization, as it was originally intended, was designed to ensure a basic level of safety for all hospitals. It has now become yet another "certifying" agency which must come up with new "critical" problems to fix in order to ensure its ongoing existence (those of you who have gone through the most recent mental masturbatory experience of banning QD and QID in orders know what I mean). What is most galling to me, however, is that hospitals must fork over a hefty sum for these frequent torture sessions, and the inspections are done not by practicing physicians or nurses, but by folks who long ago gave up the difficulties of actually caring for patients for the safety of a clipboard to hide behind.

Maybe I have my metaphors mixed up --- JCAHO comes in like the Death Star, but leaves no room for different institutions to solve problems in their own way. The JCAHO mantra can really be translated as "Resistance is futile. You will be assimilated!" As a result, I suppose JCAHO is really The Borg.
 



An oral surgeon can do it in his office, give you an IV and you won't
feel a thing.
The plastic surgeon on "The Doctors"
is very reputable. I would go to his website (can find through the show's website) and either email him or call for information/opinion.

The key is to deal with someone you know is on the ball and above board.
I received a check today from the oral surgeon. nm
 
I would see an oral surgeon, since dentists cannot perform surgery and that is probably where they
would send you to next.
Dot Richardson, olympic athlete turned ortho surgeon. nm
x
Oh, I hope you're right. The surgeon just gave her the info and kind of let her sit on it.
He didn't have time to go over it in a lot of detail. She tried to call back to have him give her more info., but he had left for the day and won't be back until Thursday. So, we'll see. Thanks for posting:)
One of mine would "tinkle and flush" an open heart surgeon true - @O
nm
I had to have a bowel resection for a Meckels diverticulum and the surgeon charged 2500 and got 1500
and the hospital bill was 27,000. Until that surgeon gets done paying malpractice, his office costs, taxes, etc. I bet he doesnt get one third of that money plus all the visits I had while in the hospital for 9 days and fu visits. I did have insurance thank God.
Every company is different -- I worked FT for one as an employee but worked a split shift - sm
So I never took breaks. I would work 5 hours, break for about 4 hours then do another 3. Another company I worked for did not care what hours you worked (IC) but wanted a min. amount of work each day, 500 for PT and 1000 for FT-- BUT they paid you by how many lines an hour you put out, the higher the lph the higher up the scale you made per line in pay; they have since changed everyone to a flat rate with incentive. But bottom line, if you are an IC it does not matter what hours you work, though many ask for a schedule and ask you to stick to it, they just want you to meet line requirements daily, i.e. 1000 per day, 1200 per day, whatever it is.
For a business ad?! A business that deals
''Transcriptsis'' x2

''with good track record''

''serve our clients of all sizes'' (I know what they mean, but I just think the wording is funny)

''strive to achieve highest possible quality'' (once again, they never met an 'article' that they didn't hate)

''all departments including H&P...'' (or a comma, for that matter)

I got up early, worked during naps, and worked when DH got home.

You have to be disciplined to make yourself work when baby is napping instead of maybe watching TV or doing housework, etc.   


I might also go the route of having a teen come into your home, or either trying a mother's morning out program at a local church/daycare.   I've been home since my youngest was born and he has never been in all-day daycare, but I did have him in a mother's morning out program 15 hours a week at a local church.   It didn't help a lot with my work schedule because I had an older son in school and was a room mom and tutored other kids, but that might be an option.  The only problem with the mother's morning out program is they are around other kids and tend to pick up every germ.  I finally took my DS out of the program because he stayed sick.  You were supposed to keep them off if they had green nasal discharge and I did, but no one else did.  Every time I got him well after 2 to 3 days back he would be sick again.  Other than that it was very good for him because he would not have had a chance to be around kids his age otherwise. 


On the other hand....
if you're an experienced acute care MT, you can pick up radiology in a month or two.  I just did it earlier this year.  Never typed a minute of radiology before and a couple months later I'm "flyin" at it.  Yes, there's a learning curve, but it's not brain surgery. 
on the other hand...
If you knew the TAT on the account when you took it on, and accepted it as such, then your obligation is to have the work done on time.  If your personal life is getting more complicated and interfering with your ability to maintain the TAT,  then maybe you should let your employer know so they can replace you with someone who can meet the TAT.  Their first obligation is to the client, after all. 
On the other hand....
Just the fact that you would be working on only one type of report would tend be for better production.
None I can think of off hand LOL!
xx
on the other hand..emp vs IC sm

status.


Anyone have experience with companies who hire you as an employee, certain hours but don't provide you with the equipment you need?  Worked for a company that did that but no medical spell checker on their software, some accounts they want YOU to buy a C-phone for etc. etc.  Asked them up front if account I would be working on would have medical speller, told yes.  It did not.  Also there was some kind of ShortHand program built in that they knew nothing about, we couldn't get to and conflicted with the autocorrect I used in Word.  Kept asking and it was always we will ask the hospital and then nothing.  Went out bought my own spell check and whatever I needed then three weeks into working, they dump the account.


Start over with a new account, different problems, they want me to buy even more stuff.  Said no I am outta here!


Anybody had that problem?


You're right .. and here's 1st-hand knowledge -- sm

I start med school (been an MT for 24 years) August 2006. 


One of my classes last semester was Intro to Medical Practices.  I especially inquired about pro bono work by all the physicians and dentists who spoke to the class as guests each week.  All gave significant amounts of their practice to pro bono work.


One physician in particular impressed me.  He is a cardiovascular surgeon.  His main area of expertise is doing cardiac bypasses.  To make a long story short, because of insurance changes (MCare) over the past few years, he only makes about $650 per bypass for his own pocket and that is gross.  Of the $1850 MCare and insurance companies pay him for this procedure, it costs him $1200 in overhead for that procedure.  Until last year, he would often do the procedure for free for patients who could not afford it and had no insurance.  However, for 2 years he had to BORROW MONEY to pay his OVERHEAD because he did so much pro bono work.  He finally decided he just could not go bankrupt doing that.  So now, he STILL does HIS PART for free but the patient has to pay his overhead.  He tells them to call their family, friends, churches and if they have the $1200 for his overhead, he will donate HIS skills/time/energy for free.


The physician (maxillofacial surgeon) who directed this class said his annual pro bono work runs around $250,000 a year. 


As well, while dentists recoup 95% to 100% of the fees charged for their services (they are ALWAYS getting their money up front), physicians (with the exception of cosmetic plastic surgery) only recoup an average of 31% of their fees.  For every $1000 they spend on a patient, they will only get back approximately $310 and must write off the rest. 


Now that is INSIDE information - direct from the physicians and dentists we had in class.  I was shocked.  Not deterred, but shocked. 


Regarding that lovely cardiologist who gives so much away, take into consideration that the $650 for HIS skills/time/energy for ONE cardiac bypass -- he invests a total of 12 to 15 hours for that one procedure (that is WITHOUT complications happening) including his consult/operative time/followup visits, hospital rounds, etc.  That comes out to about $54 an hour -- and plumbers and electricians around here make more than that.  My Ford dealership in town gets $76 an hour. 


And now, since we are starting to do bypasses endovascularly through the femoral artery, he has to really put the money down for more education to train to do this or he will be out of business shortly. 


Interesting huh?!  When people make comments to me about my future as a physician as a way to "get rich", I tell them not necessarily so!!  LOL  I'm not doing it for money!  You couldn't pay me enough to go through all this at this time in my life!!  LOL  


Because I live with it first hand

I do get offensive when someone doesn't like my children simply because of their skin tone.  I'm not saying that the OP said anything about my children or even posted about the topic.  I was just offended that she can so casually admit to being a prejudice person.  Prejudice causes hate and violence.  I take offense to that.  I think that you should, and everyone should take offense to it so that it can be stopped.  If everyone were okay with it or  no one ever stood up about the subject, where would we be? 


Also, there is a difference between knowing someone as an individual that may be a "bad seed" and be a minority and not liking them versus not liking someone without knowing them as a person simply because they are a minority.


All I know is, when those of us who are saved make it to heaven, there will be every race there right along with us, as God has created us all in his image.


Don't need hand holding.
I don't expect them to hold my hand, but it would be nice if they at least pretended to be somewhat human! Compassion for another person's loss only takes a second to respond to.... as you said in your post. It only took a second right? Most of the time I am with you, I would rather NOT hear from them. But of course I sent an e-mail to tell her that I would be out for the funeral, she could have replied with a condolence. That's all I am saying. I think that's a bit of a problem with the world in general these days, no one even seems to have time to be kind. Thank you for your second to respond and give your condolence on my loss!
Hand stress

I've transcribed since 1983.  You can lessen hand stress if you observe how you hold your hands as you type.  When I was in my twenties I noticed that there was a real difference in the way I held my hands and how the older transcriptionists (they had their wrists up and hands pointing down at the keyboard).  I have always had my wrists laying on something and my fingers are going up.  I have never had one bit of carpal tunnel or pain whatsoever.


I agree 100%, on the other hand
They are all "red" states, you would think Bush would give them a payback for giving him a job....hey, maybe if we tell him Osama Bin Laden is there he will send some troops.
Two first hand accounts..that's where
Any excuse to blame him...that's okay. Very expected. Very insignificant.
Well, Bush DOES consider himself at the right hand of The Man...

I have Short Hand. Never used the others -sm
You can install ShortHand on multiple PCs. I like it. You can actually have one shortcut for a few things (found that really, really useful). You do have to pick from the list which one you want, but I'd rather be accurate even if it might slow me down a little. It has drawbacks too though. If you forgot to put -ed on the end of a word for instance, and you go back and do that and if ed is one of your shortcuts, it will expand when you don't want it to. You can save your personal shortcut dictionary (which is nice for backup) and install it along with the program on other PCs. You can also convert an old PRD dictionary from WP if you had one and possibly others too.

It works with anything windows and you can have multiple dictionaries for multiple jobs or facilities that might have different rules.
best hand lotion..sm
This stuff is great. It's about $12.00 a bottle..maybe more now..check out Silver Lining.com ... it has MSM in it and I have actually used it to relieve my carpal tunnel pain. It's a great healing lotion. Wonderful stuff!
Help! Does anyone have first-hand experience with VR, and if so,
what about the MONEY? I do not mind learning it and am excited about the new possibilities and where MT fits; however, am I to expect a major pay reduction? I imagine full-time with benefits will no longer be an option?

Please, any substantial information will be very appreciated...I am only interested in the money, so I can pay my rent, my utilities, my groceries. I do not have a husband who supports me, so live paycheck to paycheck.

Is it possible to make any money?

Thanks all!
leg and hand edema

I have had a problem with swelling in my lower legs and feet and also my hands for the past few years now.  When this first started I had problems with headaches, went to the doctor and found my blood pressure was high.  So now I take HCTZ 75/50 once a day and do pretty well on it.  It is a pretty good diuretic and my B/P is very well controlled on it. 


In the mornings I have no swelling at all, but I notice though that by the end of my workday my hands and legs are really swollen.  My doctor says to just start exercising regularly and elevate my feet whenever possible.  I also try to avoid salt.  I'm a bit overweight so I'm sure that is not helping either. 


I'm just curious if any of you other MTs have this problem also and how you deal with it.



Hand raised...
I too tell my teens to get off the phone, bed by 10:30 usually, curfew and such. It's hard because her friends don't have curfews and she does. It's very difficult to be the "party pooper" but somebody has to.