What is Fellowship trained… and why are they the “Experts” in the field of hand and upper extremity care?
The physicians at Hand and Upper Extremity Center of Northeast Wisconsin, Ltd., have all completed accredited fellowships. This means they have gone through a competitive application process, been chosen, and completed an additional year of concentrated, specialized training in treatment of disorders of the hand and upper extremity (wrist, elbow and shoulder). This is beyond the orthopedic residency, and involves working closely with and being educated by an internationally recognized leader in our field. The fellowship allows the physicians to take the CAQ exam, and to apply for membership in the American Society for Surgery of the Hand.

Completion of a hand fellowship indicates that the physicians all have demonstrated an extra level of commitment and dedication to the field of hand and upper extremity surgery. The selection to these programs shows that our physicians demonstrated an extra level of proficiency during their residency training. And completion of the fellowship shows that they have the best possible training by the top experts in our field.

What types of problems does the Hand and Upper Extremity Center of Northeast Wisconsin diagnose and treat?
    • Traumatic injuries such as fractures of the finger, hand, wrist, forearm, elbow and shoulder
    • Lacerated tendons, nerves, or blood vessels; amputated digits; and burns
    • Arthritic problems such as rheumatoid arthritis, osteoarthritis, and other connective tissue diseases involving joints
    • Joint injuries and pain including finger, wrist, elbow, and shoulder joints.
    • Infections such as felons, paronychias, tendon sheath infections, olecranon bursa, etc.
    • Tumors such as ganglions, giant cell tumors, and the occasional malignant tumors of the hand, wrist and upper arm.
    • Diseases such as Dupuytren’s Contracture and carpal tunnel syndrome.
    • Congenital hand deformities such as webbed fingers (syndactyly), radial club hand, absent (aplastic) thumb, and supernumerary digits.
    • Complex reconstruction such as resurfacing of large skin defects following industrial injuries, or multiple tendon transfers resulting from nerve palsy.
   • Trigger finger
   • Nail bed crush or injury
   • Total shoulder replacement and revise total shoulder replacement

Is there a difference between hand surgery and other types of surgery?
The healing process makes hand and upper extremity surgery different from most other types of surgery. For example, in appendicitis the disease is cured once the diseased organ is removed; in hand and upper extremity surgery the structures within the hand and upper extremity are returned to anatomic position. However, for tendons to glide once again, nerves to transmit impulses, and joints to rotate, these structures must heal first and this, by definition, involves the formation of scar tissue. Since there are more moving parts in close relationship in the hand and upper arm than anywhere else in the body, many of these parts—even those not injured—are caught in the necessary web of the healing wound. Adhesions form between these structures. With time, the scar tissue softens and yields to the force pulling the healed tendon through it.

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Will I need therapy after surgery?
The return of good function following severe hand injuries or crippling arthritis is very possible and will occur in due time with careful Hand Therapy, the appropriate exercises, and splinting. Hand Therapy will get you past the pitfalls and through the rough spots of the post-operative period. If you want a good result, by and large it can be yours; but experience has shown that it is very difficult to achieve this alone and that your function will improve significantly faster with Hand Therapy.

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What is Hand Therapy?
Your doctor may refer you to a Hand Therapist for a prescribed rehabilitation program. Our staff, which is composed of specialty trained Occupational and Physical Therapists, will supervise you to assure that your hand or arm does not have signs of complications such as inflammation or undue swelling, and that it is healing well, an important factor that leads to a rapid return of function. The therapists will provide the active and passive exercises to prevent your joints from becoming stiff or if they are stiff, to make them more supple. They may provide custom-made splints to support joints or overcome joint contractures. They will encourage you and keep you on track during this rehabilitation phase that will vary in duration according to your particular hand problem. The Hand Therapists provide you with special service and guidance that is unique, a service which the majority of hand surgeons have neither enough hours in the day or training to provide for the optimal post-operative care that you should have. We feel fortunate to have such a department associated with us.

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How do I make an appointment?
Except for emergencies, patients are seen by appointment only. An appointment may be made by calling (920) 730-8833 or toll free (888) 383-3039 Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. All other times the telephone will be answered by our answering service, Mac-Tel.

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In the event of an emergency, every effort will be made to arrange prompt care.
Please call (920) 730-8833 for emergency service.

What if I have a question about my bill?
One of our billing specialists will be happy to assist you. We are committed to providing excellent service to our patients. We encourage you to call our office at (920) 730-8833 during office hours regarding billing questions.

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Do you prepare special reports, insurance letters, and medical-legal letters?
In accordance with the general policy of this area, a fee is charged for the preparation of special letters to insurance companies, lawyers, and other third party requesters.

Your insurance and legal reports require you, the patient, to give us permission to send this personal information by filling out a “release form”; this will be done by your attorney’s office or by your insurance company. These release forms are also available in this office upon request. There is a fee if you, the patient, request copies of your medical records.

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Do you help with insurance forms and other paperwork?
We will submit the appropriate claims submission forms to your insurance company free of charge. We will also assist you with pre-certifications and authorizations as required by your insurance company. However it is always the responsibility of the patient to fully participate in this process and to inform our office of any such requirements.

There is a fee for completion of disability and other forms. Payment of fee is required prior to completion of the form.

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What are the fees for your services?
We have a schedule of fees for all services provided from office visits to the most complicated procedures relating to injuries and disorders of the shoulder, elbow, wrist and hand. If you have questions regarding our fees please call one of our billing specialists and they will assist you. Statements are sent out monthly showing the current status of patient accounts.

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How will I be billed?
Your visit will include an examination and discussion of a treatment plan recommended for you. There is a fee for these services and for follow-up visits. Charges may be incurred for any dressing, cast, x-ray or equipment used or supplied. Any supplies not covered by insurance will be the patient’s responsibility. Payment is due at the time of your visit for co-pays and for all non-covered supplies provided.

To insure prompt processing of your claims, we require that you provide us with all primary and if applicable, secondary health insurance carriers you may have. You will also be required to provide your health insurance card(s) at the initial visit. It is your responsibility to notify us of any changes in your insurance status.

Please note that there is a potential for three (3) bills to be sent out monthly. One bill is for your physician’s care, one for therapy services, if applicable, and one from Woodland Surgery Center, if applicable.

Please understand that you, the patient, are responsible for the bills from your doctor, your therapist, and/or from Woodland Surgery Center. We accept all insurances and will bill your insurance company as a courtesy. If you insurance requires you to be seen by an in-plan provider, please make sure you verify with you insurance carrier that our clinic is in your plan. Your health insurance coverage is a contract between you and the insurance company.Your health insurance may reimburse you for part or all of your bills, but that is between you and the insurer. Approximately 1-2 weeks after a service is rendered to you, we will send a statement to you send a claim to your insurance carrier.. Normally within 30-45 days, we will receive full or partial payment from your insurance carrier. At that time, you will be billed for the difference between the insurance company's payment (if not paid in full) and the doctors fee. Balances are due in full within ten (10) days of receipt unless other payment arrangements are made. You may discuss a payment schedule with our Financial Services representative at the time of your visit or by calling (920) 730-8833.

Co-pays
Many insurance policies have co-pay amounts due at the time of the appointment. It is our policy to collect all co-pay amounts at the time of your appointment.

Does my health insurance cover all your services?
Health insurance coverage varies widely. Not all policies cover the same type of services. To ensure coverage contact your insurance carrier to verify coverage.

The doctor, however, is not a party to the transaction between the insurer and the patient. Even so, he does want to protect patients from misinterpretation.

We will ask you to sign a form assigning the payment of insurance benefits for surgical fees. The insurance company will send payment directly to us. This means one less check you have to deposit or one less check you have to make out and mail. In essence, it helps to avoid a misunderstanding in this area and maintains a rapport between patient and doctor.

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What if I don’t have health insurance?
Patients who have no insurance will be asked to make a good faith payment at each visit. You will meet with a Financial Services representative who will assist you in setting up a Payment Agreement for the balance of your fees.

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Third-party Liability
If you believe a third party is responsible for the services rendered to you as the patient, please obtain the insurance information prior to your initial visit. It is our policy to submit charges to the 3rd party for primary payment until their benefits are exhausted. Please ask to speak to our Financial Services department if you need further assistance or clarification.

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What if my injury is covered by Worker’s Compensation?
If you have already filed a 1st report of injury with your employer, it is the responsibility of the employer to notify their worker’s compensation insurance carrier of the injury. The worker’s compensation insurance carrier will assign you a claim number. Our office will need this information to process your claim. At the time of check-in at our register desk for a work related injury, a receptionist will assign a workman’s compensation representative from our clinic to meet with you. You will be given information regarding worker’s compensation, and you will also have the opportunity to ask questions that apply to your claim.

If the injury is questionable regarding work causation, the doctor will request a job description from your employer. In the event that you have a claim number and have filed your first report of injury with your employer, it does not guarantee that you have an accepted workman’s compensation claim. The worker’s compensation insurance carrier will request medical records and documentation before accepting and paying for a claim. In the event of a review and/or denial, due to the length of time some reviews can take, it is our policy to obtain your primary and/or secondary health insurance information allowing our billing department to file your claims with your health insurance carrier in a timely fashion. This will expedite processing of your claims in the instance of a Worker’s Compensation denial.

In the event of a denial, feel free to contact our workman’s compensation department and they will assist you with questions of an appeal on a denied claim.

*** If you have not filed a 1st report with your employer and feel your condition/injury is work-related, please contact your employer to discuss your condition.

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Do I need a referral?
If your insurance carrier requires that you have a authorization to visit our office, it is your responsibility to obtain that authorization. Please make sure that all authorization are received by this office before the time of your appointment.

Authorization made by the Hand and Upper Extremity Center of Northeast Wisconsin, Ltd. for tests, evaluation, or services to be provided to the patient by other providers are the full financial responsibility of the patient.

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MEDICAL RECORDS

How do I get a copy of my medical records?
A medical records release form is required to obtain a copy of your medical records. Records will be copied and mailed to you after the release form is received. There is a fee for this service. Please contact our office at (920) 730-8833 or toll free at (888) 383-3039 for more information.

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What if my insurance company or attorney needs a copy of my medical records?
All requests for medical records must be submitted in writing along with proper authorization. Requests can be faxed to (920) 831-2968 or mailed to our office:

Hand and Upper Extremity Center of Northeast Wisconsin, Ltd.
P.O. Box 7700
Appleton, WI 54912-7079

Please make sure your mailing address is included on your request.
Please call our office for more information: (920) 730-8833. Toll free: (888) 383-3039.

The physicians and staff at the Hand and Upper Extremity Center of Northeast Wisconsin hope that your care and experience with us is pleasant and productive. We appreciate the confidence you have given us by placing your care in our hands.

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Controlled Substance Medication Refill Request
There may be times when your medication will need a refill between visits. In this instance, please call our office 1-2 days before your medication runs out. Refill requests will only be taken between Monday and Friday from 8:00 a.m. to 5:00 p.m. The physician on call for the office will not refill any medication after hours or over the weekend. This is not considered an emergency and will not be treated as such.