How do I know what the NH doctor is actually doing for my Mom when he sees her?

I receive a statement every other month with nothing but numbers and codes and dollar amounts. In over a year that my Mom has been in the nursing home, the doctor has never called or written me regarding my Mom's progress or condition. He charges from $120 to $65 per visit. He gets reimbursed from Medicare and I pay the balance. The only time we ever spoke was when I had to pay out of pocket for her first month in the nursing home.

I have called his office and spoke with staff, who sent me on a wild goose chase to a call center in another country. They were no help and the communication was terrible. I actually don't understand the billing and needed clarification and so far they haven't gotten back with me.

I called the doctor's office back and asked a few questions about what I was getting for my money and the receptionist said she would have to call the nursing home and they would call me back in a day or two.

I certainly don't mind paying for services rendered but it would sure be nice to know exactly what I am paying for. Mom, has dementia and she never remembers any doctor seeing her. Not that she would let anyone touch her anyway but that is a whole other topic.

I have hired an elder care management company to oversee Mom's care and I often ask our nurse to check to see what the doctor had to say. She will report back on lab tests and medication if anything was changed.

I can't help but wonder what exactly goes on, as I live thousands of miles away and don't have first- hand knowledge. Mom often complains to me about items that I think someone who sees her twice a month should be aware of if they are physically examining her.

I don't know if the social worker in charge of her floor would be able to help me. I may call her this week. I guess, I need to know what is best way under my circumstances to develop communication with this doctor. By the way, this doctor was not Mom's primary before the nursing home. It is not an option to use her old doctor, so we must use the one on staff.

Mom also has a psychiatrist (&/or his nurse) visit occasionally and I went through the same lack of communication with him. I wrote a letter and eventually I got a call from the nurse who does most of the visits and we has a nice chat. She will also e-mail occasionally with updates.

Everything seems so impersonal. I have no one who lives near my Mom who can help me and I am the only child. Moving Mom closer to me is not an option and I doubt if I will be able to visit her in the future. Tough situation. Thanks.