Interesting To Cows

The bills for my recent medical care have been dribbling in over the past week or so and I'm a bit shocked and appalled with the whole experience.  The medical billing system seems to be entirely without checks and balances. I have no real idea what I'm being charged for (and since the insurance is paying most of it I have no real incentive to question any of it.) The whole process seems rife with inefficiency and opportunities for fraud.

There's no coordinated billing and no consolidated statement of the medical care.  I've recieved seperate bills from 2 radiology departments, the hospital, the surgeon,  the ambulance company, and am expecting several more.

None of the statements have anything but an extremely vague line item covering the total from that provider.  I have no way to sanity check the accuracy of the statements.  If they wanted to bill me for something that I never recieved (intentionally or due to a bookkeeping error) I'd have no way of knowing.

Here's what has arrived so far:

Surgery

4,300



Ambulance

388



Medical Services

225



Supplies & Materials 

25



X-rays

140



Inpatient Services

32,862

That 32K number is almost comical. Thats 16k per night for 2 nights in a hospital bed. I had an orthopedic injury, it wasn't exactly critical care. The insurance company negotiated this down to 4,500- an 85% discount. (Does anyone actually pay 32K? I'm assuming that if you don't have insurance, you probably don't have 16k per night to pay full retail.). I'd love to know what the $25 "Supply or Material" item was that apparently wasn't included in the 32k.

My out of pocket for the whole thing thus far is a little over 1k (and tax deductable) so at least I'm finally getting my money's worth for my health insurance.

The ankle continues to improve with a couple of milestones today:

- First day completely without crutches.  Able to walk with just the walking cast now.  Little bit of pain in the heel after awhile but otherwise feeling good.

- Wore a shoe on the injured foot for the first time since the surgery. 

- Drove for the first time.  Just a couple of miles to get my car back from Rahul's place.  Didn't have any difficulty pressing the pedals but angling my ankle is still a bit painful.

- First trip to the gym in 2 months.  Did a light upper body workout (mostly machines since its hard to carry freeweights with the leg) and spent 30 min on the recumbent bike on low intensity to start stretching out the ankle.

 My formal physical therapy starts on July 14th.

Ok, I figured out where some of the 15 pounds I lost over the last 6 weeks went- I've lost a fair bit of muscle mass in my injured leg.  The doc estimated it about 30%.  Lots of rehab ahead of me.

Swimming went well this afternoon, or as well as could be expected for my first bit of exercise in a month or two.  Didn't kick much and didn't risk doing flip turns. 

Got my cast off this morning.  The xrays looked good and I should eventually have a full recovery.  This is very good news given that they more or less had to completely reconstruct my ankle.

Next up is a  walking cast for 4-6 weeks.  I need to gradually start putting weight on it until I'm back to a normal gait.  For the initial phase, this just involves modifying the use of the crutches so that I'm swinging the crutches forward at the same time as my injured leg.  Normally, you'd lead with the healthy leg and bear no weight on the injured one. (Hear that Fernan?)

In a week or two I'll switch to a single crutch, followed by just the cast.  I'll be able to drive again as soon I can walk w/o crutches.  My physical therapy starts in about a month.  Curiously, I don't need to work on rotating my ankle at all- apparently that just takes care of itself.

I should be back to 100% in about a year.  Hope to be able to do some limited hiking in the fall and then back to normal for the 2007 summer season.  Going to go swimming this afternoon.

One last week with the cast.  Suprisingly, the time thus far has actually gone quickly.

Even more suprisingly, I seem to have lost about 10 pounds over the period I've been houseridden.  I guess there's something to be said for the "Physically unable to go to McDonalds" diet plan.