Discussions By Condition: Muscle conditions

Can I have BCBS NOT pay a doctor?

Posted In: Muscle conditions 2 Replies
  • Posted By: S3NTYN3L
  • June 14, 2009
  • 04:06 PM

I recently messed my wrist up at work again.

I say again because back in '02, I broke the scaphoid in my right wrist, and later found out that it resulted in a nonunion.
The following was performed as a result.

Right wrist diagnostic arthroscopy. Right radial styloidectomy. Excision of the distal pole, right scaphoid.

I was told that I could look forward to arthritis, degeneration, pain and, ultimately, bone fusion or amputation... Joy! :rolleyes:

Fast-forward six years and I'm working as a fork-lift operator.
Occasionally, I am required to hop off my stand-up style lift and manipulate a few cases or pallets. Three weeks ago I was moving some cases of paint and hurt my wrist. I thought I'd be fine just letting it rest over the weekend. I was wrong. The pain kept getting worse as the week went by. Finally, about four hours into my day, my wrist had had enough of manipulating the joystick that controls the mast & forks.

I felt this sharp pain, (as if someone stuck a pair of scissors between the Lunate and Hamate, and then opened them), this pain then radiated up my forearm. I literally thought I'd pass out from the initial pain. Needless to say, it brought tears to my eyes.

OK, well I ended up getting a referral to this ******s of a specialist who was not only very rude, but he really didn't seem to take my medical history into account. He took about five minutes (and that's being generous) to look at my hand. He rarely made eye contact and didn't really listen to me when asked to describe my issue...

So he orders some x-rays, a nerve conduction study and an MRI. (None of which he even looked at in my presence.)
I got the same treament from him upon my follow-up appointment. In fact, he actually accused my of lying to him! He said I just wanted some time off of work!!! He said he wouldn't sign the Intermittent LOA paperwork so I don't get held accountable for leaving early because of the pain. He actually argued (loudly) with the Benefits Clerk at my employer! He didn't understand (or want to understand, IMO) that he wasn't putting me out of work, but simply confirming that I wasn't lying to my employer about my condition. He claimed that there is nothing wrong with me other than the previous damage from the surgery, etc years before.

Here we are three weeks later and I'm still in constant pain. ***l, holding the remote control in my hand for longer than five minutes hurts my hand and causes my fourth & fifth fingers to "tingle" as if falling asleep. The scissor feeling I described earlier is still present when lifting anything heavier. I've tried four times since to return to work. The last day I was only able to make it two and a half hours into my ten hour day!!!

Anywho, that guy was a complete ******s.
I've since found out that he's only got 8 years experience as a plastic surgeon under his belt. He's not even an Orthopedist, can you believe that!?
Well, I've got all my results in hand and I'm going to an actual Orthopedist with 30+ years experience...

Now to my question...
I just got the claim report from my insurance company.
This clown is wanting/claiming $200 for consultation!
Considering the way he treated me, I don't think he deserves a cent!

Can I have the insurance company NOT pay this idiot?
I mean, doctors are always wanting to get paid for services rendered, but this guy did nothing other than call me a liar and watch me move my hands for about ten seconds. Show me where there were "services rendered"?

I'm still in pain. I'm VERY concerned about how I'm going to provide for my family since I can't go more than a few hours at work. (No, no light-duty or transfers possible at this point.)

I just hope this new doctor can do something for me or get some answers for me...

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2 Replies:

  • While I would agree with your assessment of your doctor, you nonetheless took up his time. To take up time - and thereby services - and not pay for it is called "theft of services". An insurance company is not going to go against their contract with their providers, and they aren't going to do something that could end up in a court of law.
    Caladan 87 Replies Flag this Response
  • Yes, but that door swings both ways.How about my time?Everyday I'm out of work, I lose $175!I've got to spend $200 for someone to belittle me, call me a liar and do nothing for me!?He LITERALLY had me move my hands for a few seconds.That was the EXTENT of his "services".He pulled up the x-rays and, I swear, his eyes didn't even focus on them he looked that quick at them. The same goes for the MRI and the NCS...I've got not problem paying for the x-rays, the NCS and the MRI.I'm talking about just the so-called doctor.I don't fell I should be financially responsible for HIM wasting my time and his...
    S3NTYN3L 5 Replies Flag this Response
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