Frequently Asked Questions About:
SURGERY OF THE HAND AND UPPER EXTREMITY
What types of problems does the Hand and Upper Extremity Center of Northeast Wisconsin
diagnose and treat?
- Congenital hand deformities such as webbed fingers (syndactyly), radial club hand, absent (aplastic) thumb, and supernumerary digits.
- Traumatic injuries such as fractures of the finger, metacarpal, or wrist bones; lacerated tendons, nerves, or blood vessels; amputated digits; and burns.
- Arthritic problems such as rheumatoid arthritis, osteoarthritis, and other connective tissue diseases involving joints.
- Diseases such as Dupuytren’s Contracture and carpal tunnel syndrome.
- Complex reconstruction such as resurfacing of large skin defects following industrial injuries, or multiple tendon transfers resulting from nerve palsy.
- 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 and
upper extremity.
- Joint injuries and pain including finger, wrist, elbow, and shoulder joints.
What can I expect after surgery?
It should be stressed at the very outset of your consultation that the goal of surgery is the return of the deformed or injured hand or upper extremity to as normal function as possible.
Is there a difference between hand surgery and other types of surgery?
The healing process makes hand surgery different from most other types of surgery. For example, in appendicitis the disease is cured once the diseased organ is removed; in hand surgery the structures within the hand 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 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.
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.
What is Hand Therapy?
Your doctor may refer you to a Hand Therapist for a prescribed rehabilitation program. Our staff, which is composed of specially 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.
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 8:30 a.m. and 5:00 p.m. All other times the telephone will be answered by our answering service, Mac-Tel.
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?
Please call the office at (920) 730-8833 during office hours regarding billing questions. Statements are sent out monthly showing the current status of patient accounts.
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.
Do you help with insurance forms and other paperwork?
All insurance forms that are for medical coverage will be completed free of charge. If covered by an insurance company that requires second opinions or pre-certification, it is the patient’s responsibility to inform our office.
The fee for completion of disability and other forms is $5 per form. This fee is required prior to completion
of the form.
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FINANCIAL POLICY
We ask that our new patients take a moment to read about our financial policy so that there will be no misunderstanding later concerning our fees and billing practices.
What are the fees for your services?
There will be a fee charged for a consultation in the office, therapy services, and for follow-up visits when indicated. A charge may be made for any special dressings, casts, x-rays, or special equipment used in the office.
We have a schedule of fees covering everything from office visits to the most complicated tendon transfer.
If you have a question regarding a specific procedure, we will be happy to discuss it with you at any time.
How will I be billed?
To insure prompt processing of your claims, we require that you provide us with all primary or 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 Hand and Upper Extremity doctor’Äôs account, one for your Hand and Upper Extremity Center therapy account, and one for your Woodland Surgery Center account.
Please understand that you, the patient, are responsible for the bills from your doctor, your therapist, and from Woodland Surgery Center. 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. 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’Äôs payment (if not paid in full) and the doctor’Äôs 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.
Does my health insurance cover all your services?
Health insurance coverage varies widely. Not all policies cover the same type of services.
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.
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.
What if my injury is covered by Worker’s Compensation?
If you believe that Worker’s Compensation is responsible for the services rendered to you as the patient, please advise your employer to mail the proper forms to our office as soon as possible. The belief that your injury is work-related does in no way ensure payment by your employer’s Worker’s Compensation insurance carrier. For that reason, we require all patients to provide us with all private health insurance information, including insurance cards, at the initial visit. This will expedite processing of your claims in the instance of a Worker’s Compensation denial.
Do I need a referral?
If your insurance carrier requires that you have a referral to visit our office, it is your responsibility to obtain that referral. Please make sure that all referrals are received by this office before the time of your appointment.
Referrals 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.
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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