Changes for Medicare Patients

With all the uncertainty about health care reform most people are most concerned about the bottom line: How much is it going to cost me?

For patients with Medicare or Medicare Advantage plans, please take a moment to read this information. It is also available in our office and you are welcome to take a copy home to read and study.

First of all, Traditional Medicare has several parts: Part A and Part B. Part A covers hospital coverage. Part B covers doctors office visits and xxxx. Part D is an optional coverage which is for prescriptions.

After meeting a predetermined deductible ($155 in 2010) you are then responsible for 20% of the cost of your office visit.

If you have any secondary, supplemental or a Managed Medicare plan these may cover that 20% you will owe. The best way to determine this is to call your secondary insurance company and ask them.

We will begin collecting your 20% responsibility at the end of your visit with the doctor starting March 1, 2010. We will make every attempt to notify you of this new change when we call to confirm your appointment a day or two before. Please be prepared to pay this at the time of your visit. This will help keep our costs down because we will not have to bill you at a later date.

We are happy to show you exactly what Medicare pays for each part of your visit and your calculated responsibility that is due.

We realize this may present a new hardship or inconvenience. Medical care costs are soaring and we do our best to keep them under control.

Dr. Roesel does not order unnecessary tests and you will find she very often asks about your prescription coverage to help make sure you get the medications you need.

Medicare premiums just went up 14%.

Medicare works this way:

You have a deductible to meet. In 2010 it is $155. After that, if you do not have secondary or supplemental insurance you are responsible for 20% of the cost of your office visit.

Effective March 1, 2010 we will be collecting this 20% from you at the end of your visit.

Why Do I Have To Pee More When It's Cold?

Did you ever come inside from the cold and almost immediately need to urinate?

When it is cold your body tries to keep your "core" warm.  The core is your heart, lungs and brain.  The way the body does this is by constricting blood vessels in your extremities like your hands and feet.

The end result is you have the same amount of blood circulating in a smaller area.  This is good for keeping your core warm but your kidneys sense too much fluid so they start making more urine.

By the time you get inside you might have a very strong urge to urinate. This is normal.

If you find that you are more thirsty later that is also normal.  Your body wants to replace the water it lost in that extra urine you made.

So now you know.

Good Urinary Habits and Bad Urinary Habits

Many of us remember Goofus and Gallant helping us learn good and bad habits, courtesy of Highlights magazine.  Unfortunately they did not teach good urinary habits.  Many of the problems we see in the office have their roots in some bad habits... but often they can be helped by adopting some good habits.

Here is a short list of "good" and "bad" habits.  See how many you have... and if you should make any changes.

GOOD HABITS

1. Drinking at least 6 glasses of fluid a day

2. Urinating at least every 4-5 hours

3. Taking your time while urinating.  Relax, close your eyes.

4. Avoiding constipation

5. Urinating before exercising

BAD HABITS

1. Going all day without urinating

2. Hurrying to urinate

3. Putting off urination when you feel the urge

4. Exercising (especially lifting weights) with a full bladder

5. Driving with a full bladder.  It can rupture in an accident if it is full.

Make one of your 2010 New Year's Resolutions to try to adopt at least one good habit and get rid of at least one bad habit!

Happy New Year 2010!

It's been a while since we posted any updates.

Here is the latest news from 4460 Red Bank Road:

1. Our practice is now one year old. We have grown more than we had ever anticipated in such a short time and are as committed as ever to providing you with the best possible experience you could have visiting a urologist.

2. We now have a full time nurse who is charming, sweet, funny and very kind. Many of our patients have mentioned how much they like her and how she puts them at ease.

3. As insurance reimbursement changes and as Medicare continues to make cuts in payments to doctors we have been examining what we are able to offer our patients and at this time, there will be no changes in the services we currently offer.

4. Insurance companies are increasingly shifting more of the cost of healthcare to the patient and this can come as a rude surprise. We not only verify your coverage when you come in for an appointment, we also can check your decuctible and see how much you have met. Many people are not aware of how this works and are surprised that they may be required to pay more in addition to their copay.

5. Our office policy is to collect copays and unmet dedectible amounts that will be due for your care at the time of your visit. What we collect is based upon the negotiated fees with your particular insurance company and the percent you are responsible for. If for any reason we have collected too much, the excess amount is promptly returned to you in a check. Alternatively, if you know you will be back you may keep the amount as a credit towards future visits.

6. All elective surgeries will require a surgical deposit prior to scheduling the surgery. This amount will be based up on your individual policy's negotiated fees for elective surgery.

7. We will be asking everyone for updated information about insurance, medications and any new health problems or changes that have occured over the last year. It is important for us to keep your record as up to date as possible.

Your allergy list is especially important to keep up to date.

8. As always, we welcome your comments and suggestions. Last year we made some significant changes based on patient comments which we feel were all good. For instance, we now have toilet seat covers in the rest room, babywipe warmers in the rooms for comfortable "clean up" and we have better candy, all thanks to patient suggestions.

9. And finally, we are very proud to have been listed in the January 2010 issue of Cincinnati magazine as one of the "Top Docs" in Urology. Check it out on page 188.

10. We hope your new year is happy, safe and healthy. Best wishes!

New Books in the Waiting Rooms

Everyone hates to wait. Especially in a urologist's office where patients dread coming in, dread what might happen and dread that it might hurt or be embarrassing.

We try to have as short a wait time as possible for our patients. We know your time is valuable and many of you have had to take off work or make arrangements for child care so you could come for your appointment.







As you know, we have the usual waiting room magazines: Oprah, Time, Architectural Digest, National Geographic, Reader's Digest Large Print, Self, Good Housekeeping, and the occasional Car and Driver.


Recently we added a few small books that have a wealth of information about some things you might have wondered about but didn't know exactly who to ask or where to find out.


And since we are plumbers, after all, it only seemed appropriate that we have these two books not only in the waiting room but in each exam room as well.

These are both really funny but very informative books. We hope you enjoy them.

Why No E-mail?

Lately we have had a number of patients who would like to be able to ask questions or communicate with Dr. Roesel via e-mail.  Our practice does not use e-mail as a form of communication with patients except for sending blank forms such as registration or medical history forms which are nice if they are completed and returned before your first appointment.

The reasons for this are several.  First, and most importantly, e-mail communications are not secure.  There are privacy laws that protect your medical information from being released to anyone but yourself and your designated individuals.  If we send medical information to you via e-mail we have no control over who could access your account and potentially see private information.

Second, all communications are considered to be part of the permanent medical records.  It is important that all questions and concerns are recorded in the record as well as the answers. We use an electronic medical record system which allows us to track calls, questions and answers and make them part of your medical record.   Although e-mails theoretically could be scanned into the record, it would be easy to forget or lose an e-mail.

We understand that many physicians now offer a special level of service to patients who wish to pay an additional fee each year and this gives them wider access to the physician via e-mail or telephone.  Our practice gives each patient the best service possible and does not charge any additional fees.    When a call with a question or a problem comes into the office it is sent to the person who is best suited to answer it.  Many medical calls are handled by Dr. Roesel's nurse.  Billing questions are handled by Dr. Roesel's office manager.  Scheduling questions are handled by our receptionist.  Please rest assured that Dr. Roesel is aware of your calls but may not be the one who answers them.

We appreciate that everyone's time is very valuable and understand fully that convenience is an important part of saving time.  We make every attempt to help you obtain care in an efficient and timely manner.   We are sorry that we cannot use e-mail for important, and private medical information.  Please remember that you are always welcome to call us at 513-271-2862.

New Guy In Town

We have a new tenant in our waiting room.  He is a Fire Belly Toad and used to live with our nurse but heard our office is a pretty nice place to live so he moved in this month.

The underside of Fire Belly toads is very colorful.  Our guy usually hides in his den behind the plant in his cage or takes a soak in his private pool.  He is not too shy so you have a pretty good chance of seeing him the next time you come to the office.