Tag Archive | UMMC

Is That Your Final Answer?

It is hard to explain what I was feeling after reviewing my invoice for surgery and discovering ” Prolene Mesh” device on the invoice.  At first I just kept thinking ” This has to be a mistake” . There was NO way a surgeon would implant a device constructed from the same material that had caused such horrific injuries. Plus He said NO NEW DEVICE.  Quickly I called the University of Maryland Medical Center Billing Department. Instantly I explained to the agent in billing that there must an error here on my invoice. She asked ” What” I was referring to? The charge for ” Prolene Mesh”, I said. This has to be a mistake. She said ” Well lets see here, Ok Yes I see that charge, she said. Why do you think it is an error? I told her, My surgeon said NO NEW DEVICE would used, Plus There is NO way he would have used this type. He saw what that material had done to my body. She advised an ” Audit” would need to be performed to determine ” if” in fact this charge was in error. They match each charge to the list of items marked used in the operating room, this process would take a few days before I would have an answer. A week later a call came from UMMC billing, The agent said she was calling with results of audit. She said charge was ” valid”, this item was in fact used during surgery, however the item was not a surgical mesh she said, it is ” Suture”. ” Suture”? Really, description says ” Prolene Mesh 30cm x 30cm , What was this a ” Suture” for King Kong? No way was I buying this, So I called the patient advocate and made a complaint. Letting the advocate know, I am a ” High Responder” to this type of material, If it was used I need to know. She then took the same approach as billing, Have an audit performed. Another week passes. During that week I was seen by the surgeon Dr. “J”, So I confronted him. I told how invoice showed charge for ” prolene mesh” and that all I wanted at this time was for him to remove it. This explained why my complications mirrored those after original surgery when 1st device was implanted. He seemed sympathetic, He said he had no idea what this item was, and he asked if he could have the invoice to do some ” research” to find out. You can have copy, I answered quickly. Now being a seasoned patient in doctor betrayal I was not taking the chance of this disappearing. Day after visit with surgeon, the patient advocate phoned with audit results. Same Answer : Item WAS used, However it is SUTURE. Serious? I am offended by their answer, they must really think I have the intellect of a rock. The description of the item on the invoice alone is enough to know this item is no suture. Now it was time I did some outside research. Having a friend that is employed with a large medical supply company, We used the ” Item #” and was able to prove exactly  ” what” this item was. It was time I left University of Maryland Medical Center & Staff know, I had proof of what the item was. In fact, I even had the catalog page, item #, and manufacture of this specific ” prolene mesh” ” Ethicon” was the manufacture. Was ” Leadership” of UMMC aware of what was going on here, maybe I should tell them. Certainly this would NOT be permitted. The letter I sent to ” Leadership” ( CEO,CFO,COO & Every other ” O” ) was straight forward & to the point. I told them, My body does not like this material. I gave them all the gory details of the past injuries it had caused. I said, Look I am Not Angry, Simply I just want to be well again. All I am seeking is ” removal” of this device. Knowing once it was removed, I would be able to heal. ” Healing” is what is has always been about, just wanting my old life back. This would do it I thought, certainly SOMEONE will make this right, Someone in charge will realize this was an amazing offer I was making here. Realizing if it was admitted that ” mesh” was used, they would fear a ” lawsuit”, I went even further in my offer. If they admit that mesh implanted and remove it, then  I would sign a release of liability. Now this was a No Brainer, Right? Just in case there was any possibility that the item really was ” Suture”, I included a ” Cashiers Check” for the cost of the device $608.96. If this was a suture, then I needed University of Maryland to purchase the item again. Once I could see it, hold it, examine it, Then & Only Then would I believe the item was a ” Suture”, Until then I knew it was surgical mesh. About a week after the letter was sent to University of Maryland Executive Office, a Call came from Risk Management/AKA Liability Insurance Carrier, AKA MMCIP. The Manager there said ” Melissa you were correct, our LATEST investigation showed the item is surgical mesh”. Finally, Thank you God, Now I will be able to heal, Well….That is what I thought.” OK”, I said, At least I finally know now, Who will be taking this out, I asked? No One she replied. Do what, what do you mean NO ONE? It has to come out, this is what is causing all my health problems. I am having FBR, It has to be removed, The longer it stays inside the more damage it will cause. We need to act quickly I tell her, My health depends on it. No One has to remove it she says, because it was a billing error. ” Just wanted you to know” she says, ” Take Care” wanting to rush off the phone. Do NOT hang up I scream, I have some questions!!! 1st: How could this be a billing error, when 3 different audits have been performed confirming the ” items” used during surgery? 2nd: This Matter has been under investigation for almost 3 months, Why was this not discovered to be a ” Billing error” before now? 3rd: How do you explain that I am having the EXACT same complications as when original device was implanted constructed from same material? 4th: Considering University of Maryland had already been paid the amount listed on the invoice ( with item included ) That would make this ” Insurance Fraud” ( Billing for medical devices NOT used) . Sad to say but the ” Risk Manager” had no answer for any of the 4 questions I presented. So just to clarify, I asked, ” What exactly are you telling me here”? Are you saying that by ” researching” you have now learned this is indeed surgical mesh, But have now discovered this ” surgical mesh” was billed in error, Correct? Yes, she said, Thats right. Well at least you now have a final answer, she said. And that was IT, End of Call. 

As the dial tone buzzed in my ear my heart just sank. My thoughts raced, What has become of ” health care”? What about the ” Do NO harm Oath” A doctor takes? Surely this was not over $600, right? My LIFE has more value than $600, RIGHT? Was admitting a mistake really that hard? Was it pride or liability that prevented the ” truth” from being spoken? Guess some questions will never get ….A Final Answer. 

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