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I know that I am not alone out here in this pit of hopelessness that I am

feeling right now. I had been working on my packet, got my 10 contacts, sent

in the online form and was working on my letter. I had been in no big rush

because was told it would be November before my insurance would be accepted

again.

Come on guys, help me, we have to help Dr. R find a way to keep up his good

work. I had been previously approved for the RNY also and turned it down

when I found out about this. It was Dr. Rutledge who educated all of us to

the benefits of MGB. How could we possibly settle for anything less....

Sincerely,

Diane Berrier

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Dear Dr. Rutledge,

Like others, I am not sure what you are actually saying in your e mail, but

you do seem to outline two problems in your practice. You are attempting a

single solution to solve both problems at one time. While it might partially

solve both problems, it does not provide the best solution to either problem.

Your first problem is the fact that you have too many patients to effectively

treat and care for. Your solution to that problem, whatever it may be, should

be a medical decision and not en economic decision. You should select your

patients strictly on a medical basis.

Your second problem is the time consuming and unpleasant task of dealing with

insurance companies. There are many effective options to deal with this

issue, other than refusing to treat patients that cannot financially afford

the surgery without insurance payment. Solutions could include charging a

fee for the service and using that fee to hire an insurance specialist on

staff. Another solution might be to charge a fee and contract out the

service. There are companies who do patient advocacy with insurers.

Doctor R. I recognize that you are a finite precious resource. I also

understand the crushing effects of being a one man band. [been there, done

that...] and I am not willing to sacrifice you for the cause, but I am also

painfully aware of the fact that what you can do is not readily available

anywhere else. Aside form separating the issues above, I think you need to

look at this from a personal goal standpoint. Where does Dr R want to be 5

years from now in his practice/professional life? 10 yrs from now?

If you are thinking palm trees and sand, stay a one man band. If you are

thinking a clinic and all that comes with time and more research etc... than

maybe it is time to bring someone else aboard and teach. I know I know, you

are already overburdened.

But this would in the long term solve one of the issues of care, and ability

to provide services.

Is it now wonderful that you are in such demand? Dr R, I am smiling because

that line was never much consolation for me.

One final thought. Dr R. what you do changes lives. It sure changed mine. I

am forever grateful to you. I am also very sad for anyone who cannot get your

help.

SG

MGB 4-12-99

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I think anyone through today's date that submitted the online form should be

allowed. (I submitted mine early this morning). But had been gathering

contacts writing the patient letter and getting my packet together. I don't

think you realize what you mean to so many of us...

Sincerely,

Diane Berrier

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In a message dated 7/28/2000 6:47:20 PM Eastern Daylight Time,

ddsdajj@... writes:

<< I think anyone through today's date that submitted the online form should

be

allowed. (I submitted mine early this morning). >>

How about Aug. 1st, that way Holly will have time to get her patient info

form in. She's been here a long time and it will give her the chance to get

to a computer that has a printer that works.

Cathy in Lenoir, NC

5' 0 "

216.5 Lbs.

BMI 42

A journey of a thousand miles begins with a single step

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In a message dated 7/28/2000 6:48:49 PM Eastern Daylight Time,

sumlinsr@... writes:

<< Sincerely and Still Hopeful

Marjory Sumlin >>

I think you will be grandfathered in Marjory if you already have your patient

info sent in .

Cathy in Lenoir, NC

5' 0 "

216.5 Lbs.

BMI 42

A journey of a thousand miles begins with a single step

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Dr. R.

I think the insurance issue is one that has an easy solution. Have it

all go through an agency designed to handle it. In CT, as well I sure, as in

NC you have companies that do this. Then your office is done with the

billing and insurance. That insurance stuff is nasty business and very time

consuming and I'm sure Debbie would love to get rid of all of this.

The second issue, and the largest issue by far is how to handle the

influx of potential new patients. As of July 31, you should stop accepting

new pt. information forms and any new potential clients. This would give you

and your office time to take a much needed breather of new clients, have time

to go over what you have already and weed out patients that you can not

accept for one reason or another. This way everyone whose name is in is

" grandfathered " . Do I like the idea of not having my name on that list? no,

not really, but since I know that I will not have my patient information in

before this date, I will not be included. I wanted to give my husband the

chance to have this done before me. so he will get healthier because his

name is in, but I won't. I won't even consider alternatives since this is

the only way everyone in my family has gone, ie, mother, sister, niece, best

friend, and next husband. so, guess I'm left out : (

Oh, well, I truly understand. After you get a grip on the patients you do

have, which could take some time, open it up again for a certain number that

are on a waiting list. Just a couple of suggestions. I'm sure we can

figure this thing out. No one wants to be excluded including me, but that's

life I guess. Hopefully, this will be figured out in a fair and equatable

manner. Ruth H. from CT.

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In a message dated 7/28/00 3:51:02 PM Pacific Daylight Time,

CMo6331945@... writes:

<<

How about Aug. 1st, that way Holly will have time to get her patient info

form in. She's been here a long time and it will give her the chance to get

to a computer that has a printer that works.

Cathy in Lenoir, NC

5' 0 "

216.5 Lbs.

BMI 42

A journey of a thousand miles begins with a single step

>>

Thank you Cathy for thinking of me..just to let you all know..I went to my

moms..used her computer and printer and my form is now submitted!!!!!!

Hugs to you all!

Holly

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Dr. Rutledge,

I would be devastated if I didn't already have a date and approval. I

understand your situation totally, but there has to be a way to help all

these other people who have just seen a glimmer of hope. Try to find a

surgeon or surgeons to learn your technique to work with you, perhaps.

Raise your fee to cover insurance personnel who have no other

responsibilities. I'm sure everyone would be more than willing to pay a

much larger fee. You are very reasonable to start with. These are just my

ideas. I know the surgeons are long term solutions, but surely there has to

be a way to help these other people. I know this must be a difficult

decision for you also.

Kay

Coming Changes

> Hi,

>

> We are overwhelmed.

>

> Our database of preop patients contains over 1500 patients and we get 5-10

> completed new patients applications per day.

>

> I get over 500 emails per day and I simply cannot answer all of them.

>

> Even with the expected addition of three new staff members and operating

in

> two rooms during the day our office is overwhelmed with new patients.

>

> While this seems good at first blush, I am afraid that I can no longer

keep

> up good quality care that I want to provide.

>

> I have to use some method of decreasing my patient load.

>

> To try and decrease our patient load we have already stopped doing

elective

> revisions of other types of failed weight loss surgery and have become

> stricter in relation to our weight and age limits. In the past we had

taken

> out a few small local advertisements and we have pulled all of these to

try

> and decrease new patient appointments.

>

> We still have many more patients than I could ever possibly take care of.

>

> I have reviewed my practice in detail and I have talked with Debbie about

> what she does and what she likes and doesn't like about the job.

>

> Clearly the most time consuming and unpleasant part of the job is dealing

> with the insurance companies.

>

> Therefore, our tentative plan is to move over the next month to no longer

> accept insurance payment for the surgery. We could still provide the preop

> letters to patients and help patients file for insurance reimbursement

post

> procedure but our efforts in this area would be limited to submitting the

> bill to the company. This would eliminate a tremendous amount of

frustration

> and paper work. The ridiculous amount of time and effort spent on hold and

> trying to address the Byzantine rules and regulations dreamed up by

> insurers would be eliminated.

>

> I would be interested in advice and suggestions about this plan.

>

> I recognize that many patients will be prevented from having the surgery,

at

> this time but I can only do so many operations and I do not want to

> compromise the quality of the care that I provide.

>

> Please give me your thoughts and feelings about this very difficult issue.

>

> RR

>

> Rutledge, M.D., F.A.C.S.

> The Center for Laparoscopic Obesity Surgery

> 4301 Ben lin Blvd.

> Durham, N.C. 27704

> Telephone #:

> Fax #:

> Email: DrR@...

>

> ************************************************

> Please Visit our Web site: http://clos.net

> ************************************************

>

> Durham Regional Hospital:

>

> Also, Please consider joining the

> Mini-Gastric Bypass Mailing List

> at http://www.onelist.com

>

> MiniGastricBypass is a general discussion of the Mini-Gastric Bypass

> ( http://www.onelist.com/community/MiniGastricBypass )

>

> Talk with lots of other Pre and Post Op

> patients and friends.

> Keep up to date on the latest news about

> the Mini-Gastric Bypass.

>

>

>

>

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

> To Unsubscribe Send and Email to:

MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

>

>

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Guest guest

Hi,

> Dr. R what about the ones that have already been approved by their

insurance

> companies and finishing up their packets for a surgery date in Aug.....

For patients that are already in progress we will continue to proceed as in

the past.

I have to do something and I am asking for advice and suggestions.

I simply cannot manage all of the patients that want to have the surgery and

the insurance battles are wearing me down.

Suggestions wanted.

RR

Rutledge, M.D., F.A.C.S.

The Center for Laparoscopic Obesity Surgery

4301 Ben lin Blvd.

Durham, N.C. 27704

Telephone #:

Fax #:

Email: DrR@...

************************************************

Please Visit our Web site: http://clos.net

************************************************

Durham Regional Hospital:

Also, Please consider joining the

Mini-Gastric Bypass Mailing List

at http://www.onelist.com

MiniGastricBypass is a general discussion of the Mini-Gastric Bypass

( http://www.onelist.com/community/MiniGastricBypass )

Talk with lots of other Pre and Post Op

patients and friends.

Keep up to date on the latest news about

the Mini-Gastric Bypass.

Re: Coming Changes

> Dr. R what about the ones that have already been approved by their

insurance

> companies and finishing up their packets for a surgery date in

Aug.....please

> reconsider this was my only hope.....you should have received my approval

> letter by now...I have a copy that they sent to me also,,,

>

>

> Kendra in WV

>

>

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

> To Unsubscribe Send and Email to:

MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

>

>

>

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Guest guest

Hi,

> Why not make the qualifying criteria a little more stiff. Line up

> your surgeries in order of life threatening co-morbidities.

>

Sickest first?

Heaviest?

Youngest?

Oldest?

Any comments?

RR

Rutledge, M.D., F.A.C.S.

The Center for Laparoscopic Obesity Surgery

4301 Ben lin Blvd.

Durham, N.C. 27704

Telephone #:

Fax #:

Email: DrR@...

************************************************

Please Visit our Web site: http://clos.net

************************************************

Durham Regional Hospital:

Also, Please consider joining the

Mini-Gastric Bypass Mailing List

at http://www.onelist.com

MiniGastricBypass is a general discussion of the Mini-Gastric Bypass

( http://www.onelist.com/community/MiniGastricBypass )

Talk with lots of other Pre and Post Op

patients and friends.

Keep up to date on the latest news about

the Mini-Gastric Bypass.

Re: Coming Changes

> Hi Dr. R,

> I was reading your post " Coming Changes " and my employers, a family

> physician, came into my office. I offered her to read the post. Her

> immediate reaction was that you are indeed a caring surgeon or you

> would not care that you no longer had quality time with your patients.

> I was thinking the same time.

>

> I would like to make this suggestion for you to consider along with

> the hundreds of suggestions I'm sure you will receive this weekend.

>

> Why not make the qualifying criteria a little more stiff. Line up

> your surgeries in order of life threating co-morbidities.

>

> Just a thought!

>

> I also liked the idea of going up on your rates so that you can

> afford additional help,but you will still have to space your patients

> a little further apart and book their surgeries a little farther out.

>

> My heart feels for you and the difficult decisions you are up against!

>

> Dinah in Alabama

>

>

>

> > Hi,

> >

> > We are overwhelmed.

> >

> > Our database of preop patients contains over 1500 patients and we

> get 5-10

> > completed new patients applications per day.

> >

> > I get over 500 emails per day and I simply cannot answer all of

> them.

> >

> > Even with the expected addition of three new staff members and

> operating in

> > two rooms during the day our office is overwhelmed with new

> patients.

> >

> > While this seems good at first blush, I am afraid that I can no

> longer keep

> > up good quality care that I want to provide.

> >

> > I have to use some method of decreasing my patient load.

> >

> > To try and decrease our patient load we have already stopped doing

> elective

> > revisions of other types of failed weight loss surgery and have

> become

> > stricter in relation to our weight and age limits. In the past we

> had taken

> > out a few small local advertisements and we have pulled all of

> these to try

> > and decrease new patient appointments.

> >

> > We still have many more patients than I could ever possibly take

> care of.

> >

> > I have reviewed my practice in detail and I have talked with Debbie

> about

> > what she does and what she likes and doesn't like about the job.

> >

> > Clearly the most time consuming and unpleasant part of the job is

> dealing

> > with the insurance companies.

> >

> > Therefore, our tentative plan is to move over the next month to no

> longer

> > accept insurance payment for the surgery. We could still provide

> the preop

> > letters to patients and help patients file for insurance

> reimbursement post

> > procedure but our efforts in this area would be limited to

> submitting the

> > bill to the company. This would eliminate a tremendous amount of

> frustration

> > and paper work. The ridiculous amount of time and effort spent on

> hold and

> > trying to address the Byzantine rules and regulations dreamed up by

> > insurers would be eliminated.

> >

> > I would be interested in advice and suggestions about this plan.

> >

> > I recognize that many patients will be prevented from having the

> surgery, at

> > this time but I can only do so many operations and I do not want to

> > compromise the quality of the care that I provide.

> >

> > Please give me your thoughts and feelings about this very difficult

> issue.

> >

> > RR

> >

> > Rutledge, M.D., F.A.C.S.

> > The Center for Laparoscopic Obesity Surgery

> > 4301 Ben lin Blvd.

> > Durham, N.C. 27704

> > Telephone #:

> > Fax #:

> > Email: DrR@c...

> >

> > ************************************************

> > Please Visit our Web site: http://clos.net

> > ************************************************

> >

> > Durham Regional Hospital:

> >

> > Also, Please consider joining the

> > Mini-Gastric Bypass Mailing List

> > at http://www.onelist.com

> >

> > MiniGastricBypass is a general discussion of the Mini-Gastric Bypass

> > ( http://www.onelist.com/community/MiniGastricBypass )

> >

> > Talk with lots of other Pre and Post Op

> > patients and friends.

> > Keep up to date on the latest news about

> > the Mini-Gastric Bypass.

>

>

>

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

> To Unsubscribe Send and Email to:

MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

>

>

>

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Guest guest

> ...I have to do something and I am asking for advice and

suggestions...

Dr. Rutledge--

Somebody mentioned in an earlier post that perhaps you could charge a

fee for the insurance work. Maybe this could be an option offered to

potential patients. While I have been approved by insurance and

would have proceeded as self-pay without the approval, I would gladly

have paid a fee to have insurance approval PRIOR to the surgery.

Maybe even a non-refundable fee of a couple hundred dollars could be

offered IF a patient wanted you to file the insurance prior to

surgery. If not, it would be up the patient to work with the

insurance and the patient would have to agree to self-pay.

I hope this makes some sense. Just a thought!

Have a great weekend and I'll see you in 1-1/2 weeks!

Dawn Jester

Wichita, Kansas

8/9/00

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Hi,

> 1. is expansion (including adding other doctors who wish to learn

> this procedure) an option?

Absolutely we are looking. It takes about a year and most surgeons are not

wild about surgery for obesity.

> 2. you guys seem to do WAY more than other doctors in terms of

> preparing materials for insurance companies and working that side of

> things. can you push that responsibility back to the patients? also,

> I know at least one other Dr I got info from (champion in Atlanta, I

> think) charges a non-refundable $50 to submit info to insurance.

Isn't that the same thing??

> I

> know your goal isn't to make more money, but to cut back on patients,

> but maybe those steps would weed out some of the people who aren't

> willing to make a major commitment, or who have NO chance of winning

> insurance approval.

??

> 3. could you just start scheduling people farther and farther out?

> again, seems like this would move some people to other procedures in

> and of it self...

We are working on 1500 patients and get 10 new contacts a day.

> 4. if you can't find something that works other than eliminating

> insurance patients, I'd like to add my weight (pun intended) to the

> request to grandfather in those of us who have already submitted

> paperwork

Sounds fair to me. Should we consider a date??

> and are trying to get insurance approval. I turned down my

> insurance company's approval for RNY to try to get them to approve

> this...if after all this paperwork and red tape, I finally get

> approval and then tell them " psych! they don't take insurance! " not

> only will it be a crushing blow to me, it will have wasted hundreds

> of hours of time of all kinds of people, and is certainly not going

> to endear me to any of these people when I go back and try to get

> them to approve anything else.

> 5. if you do go to cash only, would you consider adding some kind of

> payment option?

I expect that keeping track of payments would be about as much fun as the

insurance side of things.

and would you expect costs to go down, since I assume

> your costs would go down (not having to hassle with insurance or take

> low insurance amounts)? I think your costs are pretty reasonable

> anyway, just wondering.

I think we are the most inexpensive surgery in the world right now but I

guess we could make it cheaper.

I am not sure that would help decrease our patient load though.

RR

Rutledge, M.D., F.A.C.S.

The Center for Laparoscopic Obesity Surgery

4301 Ben lin Blvd.

Durham, N.C. 27704

Telephone #:

Fax #:

Email: DrR@...

************************************************

Please Visit our Web site: http://clos.net

************************************************

Durham Regional Hospital:

Also, Please consider joining the

Mini-Gastric Bypass Mailing List

at http://www.onelist.com

MiniGastricBypass is a general discussion of the Mini-Gastric Bypass

( http://www.onelist.com/community/MiniGastricBypass )

Talk with lots of other Pre and Post Op

patients and friends.

Keep up to date on the latest news about

the Mini-Gastric Bypass.

Re: Coming Changes

> rats! since i am several months into my insurance appeal, this is

> certainly not welcome news. but obviously, you've got to do

> something. couple of suggestions, which you probably already thought

> of:

> 1. is expansion (including adding other doctors who wish to learn

> this procedure) an option?

> 2. you guys seem to do WAY more than other doctors in terms of

> preparing materials for insurance companies and working that side of

> things. can you push that responsibility back to the patients? also,

> i know at least one other dr i got info from (champion in atlanta, i

> think) charges a non-refundable $50 to submit info to insurance. i

> know your goal isn't to make more money, but to cut back on patients,

> but maybe those steps would weed out some of the people who aren't

> willing to make a major commitment, or who have NO chance of winning

> insurance approval.

> 3. could you just start scheduling people farther and farther out?

> again, seems like this would move some people to other procedures in

> and of it self...

> 4. if you can't find something that works other than eliminating

> insurance patients, i'd like to add my weight (pun intended) to the

> request to grandfather in those of us who have already submitted

> paperwork and are trying to get insurance approval. i turned down my

> insurance company's approval for RNY to try to get them to approve

> this...if after all this paperwork and red tape, i finally get

> approval and then tell them " psych! they don't take insurance! " not

> only will it be a crushing blow to me, it will have wasted hundreds

> of hours of time of all kinds of people, and is certainly not going

> to endear me to any of these people when i go back and try to get

> them to approve anything else.

> 5. if you do go to cash only, would you consider adding some kind of

> payment option? and would you expect costs to go down, since i assume

> your costs would go down (not having to hassle with insurance or take

> low insurance amounts)? i think your costs are pretty reasonable

> anyway, just wondering.

>

>

>

>

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

> To Unsubscribe Send and Email to:

MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

>

>

>

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Guest guest

>

> I guess the only thing I wonder is this retroactive to everyone or to new

> people just now sending in their request.

>

Sounds fair.

RR

Rutledge, M.D., F.A.C.S.

The Center for Laparoscopic Obesity Surgery

4301 Ben lin Blvd.

Durham, N.C. 27704

Telephone #:

Fax #:

Email: DrR@...

************************************************

Please Visit our Web site: http://clos.net

************************************************

Durham Regional Hospital:

Also, Please consider joining the

Mini-Gastric Bypass Mailing List

at http://www.onelist.com

MiniGastricBypass is a general discussion of the Mini-Gastric Bypass

( http://www.onelist.com/community/MiniGastricBypass )

Talk with lots of other Pre and Post Op

patients and friends.

Keep up to date on the latest news about

the Mini-Gastric Bypass.

Re: Coming Changes

> In a message dated 7/28/2000 1:48:40 PM Eastern Daylight Time,

> Dr_Rutledge@... writes:

>

> << Therefore, our tentative plan is to move over the next month to no

longer

> accept insurance payment for the surgery. We could still provide the

preop

> letters to patients and help patients file for insurance reimbursement

post

> procedure but our efforts in this area would be limited to submitting the

> bill to the company. This would eliminate a tremendous amount of

frustration

> and paper work. The ridiculous amount of time and effort spent on hold

and

> trying to address the Byzantine rules and regulations dreamed up by

> insurers would be eliminated. >>

>

> Well, Dr. Rutledge I can't say that I don't totally understand. I do not

see

> how you have kept up the pace you and your office have.

>

> I guess the only thing I wonder is this retroactive to everyone or to new

> people just now sending in their request.

>

> Cathy Jo Morrow in Lenoir, NC

> 5' 0 "

> 216.5 Lbs.

> BMI 42

> A journey of a thousand miles begins with a single step

>

>

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

> To Unsubscribe Send and Email to:

MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

>

>

>

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Guest guest

Thank you for this update! Question: Does this mean those pursueing

at this point are now considered " ineligible " ?

Joannie

Irving, TX

" Rutledge, M.D., F.A.C.S. " wrote:

> Hi,

>

> We are overwhelmed.

>

> Our database of preop patients contains over 1500 patients and we get

> 5-10

> completed new patients applications per day.

>

> I get over 500 emails per day and I simply cannot answer all of them.

>

> Even with the expected addition of three new staff members and

> operating in

> two rooms during the day our office is overwhelmed with new patients.

>

> While this seems good at first blush, I am afraid that I can no longer

> keep

> up good quality care that I want to provide.

>

> I have to use some method of decreasing my patient load.

>

> To try and decrease our patient load we have already stopped doing

> elective

> revisions of other types of failed weight loss surgery and have become

>

> stricter in relation to our weight and age limits. In the past we had

> taken

> out a few small local advertisements and we have pulled all of these

> to try

> and decrease new patient appointments.

>

> We still have many more patients than I could ever possibly take care

> of.

>

> I have reviewed my practice in detail and I have talked with Debbie

> about

> what she does and what she likes and doesn't like about the job.

>

> Clearly the most time consuming and unpleasant part of the job is

> dealing

> with the insurance companies.

>

> Therefore, our tentative plan is to move over the next month to no

> longer

> accept insurance payment for the surgery. We could still provide the

> preop

> letters to patients and help patients file for insurance reimbursement

> post

> procedure but our efforts in this area would be limited to submitting

> the

> bill to the company. This would eliminate a tremendous amount of

> frustration

> and paper work. The ridiculous amount of time and effort spent on hold

> and

> trying to address the Byzantine rules and regulations dreamed up by

> insurers would be eliminated.

>

> I would be interested in advice and suggestions about this plan.

>

> I recognize that many patients will be prevented from having the

> surgery, at

> this time but I can only do so many operations and I do not want to

> compromise the quality of the care that I provide.

>

> Please give me your thoughts and feelings about this very difficult

> issue.

>

> RR

>

> Rutledge, M.D., F.A.C.S.

> The Center for Laparoscopic Obesity Surgery

> 4301 Ben lin Blvd.

> Durham, N.C. 27704

> Telephone #:

> Fax #:

> Email: DrR@...

>

> ************************************************

> Please Visit our Web site: http://clos.net

> ************************************************

>

> Durham Regional Hospital:

>

> Also, Please consider joining the

> Mini-Gastric Bypass Mailing List

> at http://www.onelist.com

>

> MiniGastricBypass is a general discussion of the Mini-Gastric Bypass

> ( http://www.onelist.com/community/MiniGastricBypass )

>

> Talk with lots of other Pre and Post Op

> patients and friends.

> Keep up to date on the latest news about

> the Mini-Gastric Bypass.

>

>

> -----------------------------------------------------------------------

>

> -----------------------------------------------------------------------

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Guest guest

Hi,

I think everyone that is now " in process " should expect that they will be

treated under the " old " rules.

The " new " rules are up for discussion.

I am asking for help and advice.

Nothing is fixed yet.

But I am sure it is obvious that I can only operate upon a limited number of

patients.

We have to do something to limit the patients.

And I really honestly do dislike the insurance company thing.

RR

Rutledge, M.D., F.A.C.S.

The Center for Laparoscopic Obesity Surgery

4301 Ben lin Blvd.

Durham, N.C. 27704

Telephone #:

Fax #:

Email: DrR@...

************************************************

Please Visit our Web site: http://clos.net

************************************************

Durham Regional Hospital:

Also, Please consider joining the

Mini-Gastric Bypass Mailing List

at http://www.onelist.com

MiniGastricBypass is a general discussion of the Mini-Gastric Bypass

( http://www.onelist.com/community/MiniGastricBypass )

Talk with lots of other Pre and Post Op

patients and friends.

Keep up to date on the latest news about

the Mini-Gastric Bypass.

Coming Changes

>

>

> > Hi,

> >

> > We are overwhelmed.

> >

> > Our database of preop patients contains over 1500 patients and we get

5-10

> > completed new patients applications per day.

> >

> > I get over 500 emails per day and I simply cannot answer all of them.

> >

> > Even with the expected addition of three new staff members and operating

> in

> > two rooms during the day our office is overwhelmed with new patients.

> >

> > While this seems good at first blush, I am afraid that I can no longer

> keep

> > up good quality care that I want to provide.

> >

> > I have to use some method of decreasing my patient load.

> >

> > To try and decrease our patient load we have already stopped doing

> elective

> > revisions of other types of failed weight loss surgery and have become

> > stricter in relation to our weight and age limits. In the past we had

> taken

> > out a few small local advertisements and we have pulled all of these to

> try

> > and decrease new patient appointments.

> >

> > We still have many more patients than I could ever possibly take care

of.

> >

> > I have reviewed my practice in detail and I have talked with Debbie

about

> > what she does and what she likes and doesn't like about the job.

> >

> > Clearly the most time consuming and unpleasant part of the job is

dealing

> > with the insurance companies.

> >

> > Therefore, our tentative plan is to move over the next month to no

longer

> > accept insurance payment for the surgery. We could still provide the

preop

> > letters to patients and help patients file for insurance reimbursement

> post

> > procedure but our efforts in this area would be limited to submitting

the

> > bill to the company. This would eliminate a tremendous amount of

> frustration

> > and paper work. The ridiculous amount of time and effort spent on hold

and

> > trying to address the Byzantine rules and regulations dreamed up by

> > insurers would be eliminated.

> >

> > I would be interested in advice and suggestions about this plan.

> >

> > I recognize that many patients will be prevented from having the

surgery,

> at

> > this time but I can only do so many operations and I do not want to

> > compromise the quality of the care that I provide.

> >

> > Please give me your thoughts and feelings about this very difficult

issue.

> >

> > RR

> >

> > Rutledge, M.D., F.A.C.S.

> > The Center for Laparoscopic Obesity Surgery

> > 4301 Ben lin Blvd.

> > Durham, N.C. 27704

> > Telephone #:

> > Fax #:

> > Email: DrR@...

> >

> > ************************************************

> > Please Visit our Web site: http://clos.net

> > ************************************************

> >

> > Durham Regional Hospital:

> >

> > Also, Please consider joining the

> > Mini-Gastric Bypass Mailing List

> > at http://www.onelist.com

> >

> > MiniGastricBypass is a general discussion of the Mini-Gastric Bypass

> > ( http://www.onelist.com/community/MiniGastricBypass )

> >

> > Talk with lots of other Pre and Post Op

> > patients and friends.

> > Keep up to date on the latest news about

> > the Mini-Gastric Bypass.

> >

> >

> >

> >

> >

> > This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> > Please visit our web site at http://clos.net

> > Get the Patient Manual at http://clos.net/get_patient_manual.htm

> >

> > To Unsubscribe Send and Email to:

> MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

> >

> >

>

>

>

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

> To Unsubscribe Send and Email to:

MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

>

>

>

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Guest guest

DR. Rutledge:

I agree with the being grandfathered in. I had previous weight loss surgery

done and back in June you asked me to wait 6 months. Since all of my

paperwork was in and completed, won't you consider grandfathering us in. I,

too, have been looking forward and practically living for this surgery. I

have been waiting patiently or maybe not so patiently for November to

approach you again. Please tell me my hopes are not for nothing. Sharon

Coming Changes

> Hi,

>

> We are overwhelmed.

>

> Our database of preop patients contains over 1500 patients and we get 5-10

> completed new patients applications per day.

>

> I get over 500 emails per day and I simply cannot answer all of them.

>

> Even with the expected addition of three new staff members and operating

in

> two rooms during the day our office is overwhelmed with new patients.

>

> While this seems good at first blush, I am afraid that I can no longer

keep

> up good quality care that I want to provide.

>

> I have to use some method of decreasing my patient load.

>

> To try and decrease our patient load we have already stopped doing

elective

> revisions of other types of failed weight loss surgery and have become

> stricter in relation to our weight and age limits. In the past we had

taken

> out a few small local advertisements and we have pulled all of these to

try

> and decrease new patient appointments.

>

> We still have many more patients than I could ever possibly take care of.

>

> I have reviewed my practice in detail and I have talked with Debbie about

> what she does and what she likes and doesn't like about the job.

>

> Clearly the most time consuming and unpleasant part of the job is dealing

> with the insurance companies.

>

> Therefore, our tentative plan is to move over the next month to no longer

> accept insurance payment for the surgery. We could still provide the preop

> letters to patients and help patients file for insurance reimbursement

post

> procedure but our efforts in this area would be limited to submitting the

> bill to the company. This would eliminate a tremendous amount of

frustration

> and paper work. The ridiculous amount of time and effort spent on hold and

> trying to address the Byzantine rules and regulations dreamed up by

> insurers would be eliminated.

>

> I would be interested in advice and suggestions about this plan.

>

> I recognize that many patients will be prevented from having the surgery,

at

> this time but I can only do so many operations and I do not want to

> compromise the quality of the care that I provide.

>

> Please give me your thoughts and feelings about this very difficult issue.

>

> RR

>

> Rutledge, M.D., F.A.C.S.

> The Center for Laparoscopic Obesity Surgery

> 4301 Ben lin Blvd.

> Durham, N.C. 27704

> Telephone #:

> Fax #:

> Email: DrR@...

>

> ************************************************

> Please Visit our Web site: http://clos.net

> ************************************************

>

> Durham Regional Hospital:

>

> Also, Please consider joining the

> Mini-Gastric Bypass Mailing List

> at http://www.onelist.com

>

> MiniGastricBypass is a general discussion of the Mini-Gastric Bypass

> ( http://www.onelist.com/community/MiniGastricBypass )

>

> Talk with lots of other Pre and Post Op

> patients and friends.

> Keep up to date on the latest news about

> the Mini-Gastric Bypass.

>

>

>

>

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

> To Unsubscribe Send and Email to:

MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

>

>

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Guest guest

> Hi,

>

> No one who is here now should be excluded. That is my thought.

>

> We are talking about setting a date to affect future patients.

>

> What would be fair?

>

> Everyone who has submitted their form up to a certain date should

be OK.

>

> When?

>

> RR

>

Since it seems as all in process patients are going to

be " grandfathered " , how about all new applications as of tommorrows

date (7/29/00) be entered into a database on a hopefuls waiting list

basis. This would allow the in process patients to have their day

and the future hopefuls to have a chance. If you put all future

hopefuls on a waiting list status your patient load will slow as the

procedure is performed and a waiting list would give you a way to

keep in contact with future hopefuls and continue the help that so

many are requesting. This waiting list could be handled on a date of

entry basis along, I am sure that anybody wanting you to do the

procedure will be happy to be on your waiting list. This would give

hope to those that are willing to wait for your procedure. We will

all have to realize that one person can not perform as many surgeries

in a day as what there are people that want the MGB. We will have to

be patient and wait our turn. Easier said than done, I know.

Patience is not one of my virtues.

Just some thoughts......

Rhonda

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Guest guest

Sharon Cindy wrote:

>

> DR. Rutledge:

>

> I agree with the being grandfathered in. I had previous weight loss

> surgery done and back in June you asked me to wait 6 months. Since all of my

> paperwork was in and completed, won't you consider grandfathering us

> in. I, too, have been looking forward and practically living for this

> surgery. I have been waiting patiently or maybe not so patiently for November

to

> approach you again. Please tell me my hopes are not for nothing.

> Sharon

Sharon,

When Dr. R. is trying to decide on guidelines for his future patient

load, if you think about it, should he help 7-8 patients who have never

had weight loss surgery or spend the same 4 hours doing one revision?

I'm not trying to be a butthead about this, I'm just trying to look at

it objectively and if it were my call to make, this is one of the issues

I would be weighing and how I see it.

If it came down to it, don't you have other options, i.e., couldn't you

get a lap RNY? What type of surgery did you have before? How hard will

it be to reverse?

Kind regards,

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Guest guest

Dear Dr Rutledge, Please tell me it isn't so for the people who have

already spent literally months trying to accomplish the time

consuming and difficult task of preparing the pre-op packet. I have

been approved by my insurance company and after much hassling with

doctors, medical groups, tests, and considerable expense both

emotionally and financially, to have my packet ready to send to you,

and then discover that all of this effort may have been in vain is

not only devastating personally, but is really unfair to all the

others who have worked so hard to have you as their doctor of choice.

Please clarify your position about people on the brink of realizing

this live saving surgery. When will the new conditions begin and whom

will they apply to? To have failed all my life at trying to lose

weight and then find that I have failed at achieving the solution to

my weight and health problems because I was too late will be more

injury to my self-esteem. I implore you to consider those of us who

have worked so hard already, and address this matter in a kind and

thoughtful manner. My husband and I have discussed previously the

possibility that you would become too successful, but naturally we

hoped it would not happen before I received this surgery. We

understand a little about having more to do than time to do it, and

we trust your good judgment in this decision that you must make.

Sincerely and Still Hopeful

Marjory Sumlin

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