Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 > ...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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 > > 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 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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. > > > ----------------------------------------------------------------------- > > ----------------------------------------------------------------------- > 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 > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 > 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 Quote Link to comment Share on other sites More sharing options...
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