hand, wrist, sprain, fracture, nerve, tendon injury, ligament, congenital hand surgery, hand surgeon, wrist surgeon, wrist pain, wrist arthroscopy, scafoid surgery, cerebral palsy hand treatment, arthritis hand, carpal tunnel surgery, dupuytrens surgery, scafoid, wrist pain
How do I get referred?
Mr Maxim Horwitz is happy to receive referrals from a variety of sources. However you should check with your insurance company whether you require a referral letter from your general practitioner. If you wish to make an appointment the telephone number is 020 8150 8290.
What do I need for my first consultation?
A referral letter from either your general practitioner or physiotherapist is required. This may have already been sent direct to Mr Horwitz's office. You should also bring your insurance policy number and authorisation code for the consultation. Any X-rays, MRI scans or previous correspondence should also be brought with to the consultation.
How long will the consultation last?
The standard new patient consultation lasts up to 30 minutes. Some conditions are very simple and a through explanation including demonstrations with anatomical models can take less time than this. Some complex conditions can take much longer and the office usually identifies these patients and makes allowances for extra time. Follow up appointments last up to 15 minutes but again can vary. Either way Mr Horwitz is confident that at the end of the consultation enough time has been given to fully explain the issues involved.
How much does a consultation cost?
Costs are usually covered by your insurance company as they are within the normal guidelines. Please discuss matters further with the office if you have any queries regarding this. Prices are set according to the scales produced by the major insurance companies on all of whose lists Mr Maxim Horwitz is registered. Mr Horwitz is recognised as a Provider by all the leading insurers and will charge reasonable and customary rates which, with very few exceptions, are accepted by the Insurer.
If you a self pay patient Mr Horwitz's fee for an initial consultation is £250 and a follow up consultation fee is £150. Further cost information can provided upon request.
Will I need an X-ray?
Conditions that affect bone such as fractures and arthritis often need x-rays. An x-ray will be done on the same day and the results discussed with you by Mr Horwitz. Most Insurance companies cover x-rays as part of the initial authorisation, but please check first.
If you are a self pay patient the Hospital will charge you directly for x-rays.
What if I need a Scan?
Scans (MRI, CT, and ultrasound) are expensive and authorisation is almost always required by the insurance companies. Scans are usually performed on a separate day and a follow up appointment required discussing the results. On the day of the scan we request patients make a follow up appointment for a week by which time the radiology doctor will have had time to review the images and write a report and discuss this with Mr Horwitz.
What if I need Surgery?
The decision for surgery is not always easy and adequate time will be offered to ensure you understand what is involved. Often Mr Horwitz will arrange for patients to see the specialist Hand therapist before surgery to discuss the rehabilitation post operatively if particularly involved. Once you have decided on surgery you will be consented for the operation and an OPCS code given. A suitable date will be discussed with Karen my Practice Manager.
What is Consent?
Consent is a very important part of the surgical process. It is the process in which the patient and surgeon have the opportunity to discuss the planned surgery in detail and be fully aware of the risks and benefits. A signed document outlining the procedure, risks and benefits is filed in the notes and a copy is retained for the patient.
What is the OPCS code that my insurer asked me to obtain?
The OPCS code will represent a particular operation. It will usually consist of a capital letter followed by four numbers. For example a carpal tunnel decompression operation will have the OPCS code A6510. Mr Horwitz should be able to give you the code once a decision has been made to perform surgery. Occasionally multiple OPCS codes are required for one operation and this would represent two or more different procedures being performed in the one operation. Once you have been given the OPCS code you should inform your insurance company to obtain authorisation.
What are Day Case and in-Patient?
These terms describe the amount of time spent in the hospital. A day case operation is performed and the patient is allowed home on the same day. An In-patient is kept in overnight following surgery. This may be for a variety of reasons such as co-existing medical conditions, social circumstances, more careful observation required etc.
Who will do my operation?
Mr Maxim Horwitz performs all private operations. Occasionally for complex cases he is assisted by another experienced surgeon. There will be no extra costs incurred if an additional surgical assistant is required.
Who will I see after my operation?
Mr Horwitz will check that you are comfortable and in a satisfactory condition to leave the hospital. You will be followed up in the outpatients department either by a nurse, a hand therapist or by Mr Horwitz. Patients may be seen for mobilisation or splinting by a hand therapist in the first week or two to have their stitches removed. Mr Horwitz will see a patient for a follow up after a week or so.
What if things go wrong?
Complications are fortunately quite rare in hand and wrist surgery. However they still can occur. The close post operative attention that you will receive from the nurses, hand therapist and Mr Horwitz would hopefully identify and problems early so that they can be rectified. You are free to call Mr Horwitz at any time through our office number 0208 150 8290 or the hospital switchboard in a genuine emergency.