Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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 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, Are you saying that only cash will be accepted for future surgeries? Diane 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 1:48:38 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. > Please reconsider Dr. R..it just wouldn't be fair that only those who could afford it would be allowed to have the surgery. I have been researching and spending so much of my time on this and I know for me and many others it is our only hope. Holly in Illinois 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, It's the old supply and demand scenario. You are in great demand, but there is only so much supply of you! It's a great problem to have, though. How about taking a couple spanking new surgeons under your wing and clone yourself? I would imagine it would be your dream, anyway, to have others perform the surgery you invented. Why not have them be there with you at the center? Insurance companies rule the world and are a real nightmare, no one would argue that, I just think it would be so sad and unjust that people who desperately need this surgery, and cannot afford it on their own would be out of luck. What about raising your rates and hiring someone to do nothing but insurance? It's ironic that the computer age has helped to get your surgery " out there, " but maybe has worked too well! Whatever you decide, I wish you and your wonderful staff all the best! Regards, Debbie in IL Daughter MGB 8/9 Cigna (3rd appeal)--BMI 45 Counting on Cigna for Debbie (BMI 40) First request denied 7/21 :0( 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 3:02:05 PM Eastern Daylight Time, DebLaMan@... writes: > > What about raising your rates and hiring someone to do nothing but insurance? > > How about ?? maybe she wants to quit her job as an attorney! ok..I don't even know how I can joke when I am sitting here in tears wondering what will happen to me and other pre-ops. 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, When I found this site I was given hope for the first time in 20 years. Now I sit here completely devestated. I had debated this with my family and at 10 o'clock this morning submitted my online form only to come home this afternoon and find out that the hope is fading. Does this include the hospital stay also? Will they still bill the insurance company if you have a preauthorization? That would make a big difference. I want to live long enough to watch my children grow up. To be healthy and be able live which is something I have put on hold my whole life. I guess that many of us will have to resort to a surgery that is not as safe and much more costly just to be able to have it. There must be something that can be done. This is a tragedy to all of us who are out here in limbo. Please, Dr. R, I beg you to help us find a way to get this surgery. 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 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 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, Could you not just change to the way many(more probably most)Dr's handle the insurance nightmare and only file for the companies you choose to contract with?And could you only read the posts sent directly to your address,w/instructions what to & what NOT to make contact about? Janet Whitaker ________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com 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 4:28:56 PM Eastern Daylight Time, dnjester@... writes: > > 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. > Money isn't the issue..its his time and the time of the staff so how is this going to cut down on patients? Gosh..I have turned 3 people this week on to your site...now I feel bad!! We do need a cloning machine! There has to be a way to work this all out to benefit Dr. R and us hopefuls! Holly 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 4:29:16 PM Eastern Daylight Time, Dr_Rutledge@... writes: > > > > 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. > Dr. R... Just a suggestion of a surgeon I know..maybe he would relocate..he is a good surgeon, and has great bedside manner. He also has experience with weight loss surgery. His name is Frantz in Decatur, Illinois. It might be worth a shot just to talk to him and see if he is interested. He did my gallbladder surgery 14 years ago. Holly 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 4:30:13 PM Eastern Daylight Time, Dr_Rutledge@... writes: > > > 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 Are you going to put a date in to when the cutoff is as to having paperwork in? Does this include the Patient Info online form or the whole packet? I was submitting my online form today! (After 4 months on this list and learning a lot!!) Holly 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 4:44:13 PM Eastern Daylight Time, ybuzzy@... writes: > > Why not send your billing out to a billing service - I am sure there are > some in > the area, and if not, then someone should start one. A fee could be tacked > on > to each insurance patient's bill which would pay the service to handle the > billing. Your office would then only be responsible for sending the > original > request to the insurance company for precertification. I assume this is a > pretty standard form letter that you have on computer and can just fill in > the > " blanks " with each patient's co-morbidities etc. Joanne in Ohio > Now..thats a GREAT idea! 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 5:35:15 PM Eastern Daylight Time, Dr_Rutledge@... writes: > > 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 > Well, at least give me time to run to my moms so I can do it! My printer is broken! lol! say 2 hours from now..just kidding! Maybe extend it a week or two from now so all of us that have been on this support group can have time to get ours done at least. My 2 cents again! 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. R. I certainly understand the move in this direction. I have been fighting with my insurance since February. I now have an appeal into the NC Insurance Commission. My question is will the patients in the your database who have been waiting and working on their appeals be " grandfathered " under your new policy? Many of us cannot possibly afford this surgury without insurance and those of us who can, risk being denied insurance should there be any type of complication. I am still hopeful that I will be able to have this surgury. It is what keeps me going everyday, please consider grandfathering those of us who are already dreaming of better days. Thank you, Rozycki, MGB hopeful since 2/19 > 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 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. 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 7:04:20 PM Eastern Daylight Time, happygirl0925@... writes: << hank 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 >> That's wonderful!!!! Congratulations!!!!!!! I think I was gonna cry if you didn't. 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 Dear Dr. Rutledge, I guess my first thought is selfish. It is the same as 's. Please consider " grandfathering " those of us that are in the appeal stage. I am afraid that if I have the surgery before I have the insurance company's approval they will refuse to pay after the fact. How do you fight the insurance companies after you have already had the surgery? Is August or September when you are thinking of no longer accepting insurance payment? If we pay up front, will everyone get the self-pay discount or will you stop giving the discount? I'm willing to wait on you until you have the time to do the surgery. I was wondering how your office staff spends so much time on the phone with insurance companies? I have been dealing with them on my own other than the appeal letter from Dr. Rutledge. If everyone deals with their own insurance problems, would that help with the overload any? What is the Byzantine rules? I hope you are able to find a solution to this overwhelming problem. I was just starting to feel like there might be hope for me again. Please keep us informed. Thanks for your consideration, Rhonda 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, 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. 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. Rutledge ! I have been thinking and thinking about this since I first read your post this afternoon. I truly do not envy your position, I always loved to read your posts, because you are just about the coolest Doctor i've ever seen, but it is obvious how upset this makes you from the tone of your emails, we can all see how hard this is, and no decision that is made will be great news for everyone...what's the saying...you can please some of the people some of the time..but not all of the people all of the time...anyway...I have some suggestions I'd like to add if I may... #1 The online patient info sheet takes about two hours at the most for us to complete, could you maybe set a cut off date for all Patients to have their online info sheets submitted to your office by July 31st. I first thought maybe Aug 15th, but if you are receiving 20 PI forms a day, you're talking about another 340 patients. Now what you maybe could do is that anyone submitting between 8/1 - 8/15 is required to obtain insurance approval themselves, and after 8/15 do not accept anymore PI forms for a while. You could do like an enrollment period like the insurance companies do. Perhaps take the next 6 months to a year to get to a position where you feel your Standard of Care is not jeopardized, and then perhaps open the " enrollment " period to maybe the first 500 patients, then close down again for 6 months. Insurance approval, well at least mine is good for 6 months. This will enable people the time to get their packet together, get their insurance approval and be ready to go when the enrollment period begins again. I know it is seems easy for me to say, but it really is not. I sent in my packet to you yesterday, and am hoping for a date in Sept, but I know if I were in the middle of this, I would still wait for you. This at least does not elimate those that may never have the money for this surgery, it just delays it a bit, and at the same time gives you time to give the care that you feel comfortable with, and also elevates the time your very over worked staff spends in obtaining insurance approval. > >Reply-To: MiniGastricBypass (AT) egroups (DOT) com >To: <MiniGastricBypass (AT) egroups (DOT) com> >Subject: Re: Coming Changes >Date: Fri, 28 Jul 2000 16:23:00 -0400 > >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 > > > > > > > > > > >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 > > ________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 Why not send your billing out to a billing service - I am sure there are some in the area, and if not, then someone should start one. A fee could be tacked on to each insurance patient's bill which would pay the service to handle the billing. Your office would then only be responsible for sending the original request to the insurance company for precertification. I assume this is a pretty standard form letter that you have on computer and can just fill in the " blanks " with each patient's co-morbidities etc. Joanne in Ohio Rutledge, M.D., F.A.C.S. wrote: > 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 > > > > > > > > > > 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 just finished reading all of the posts (so far) regarding this subject. I assume (pray) the surgeon portion of the bill is the only $$ that will be affected by this decision. If memory serves that is about +-$4000. I don't know how a lot of people would come up with that kind of money-I for one have 6 kids with 4 who are about to go into college and I do not think I can scrape that much together before the end of September. I know my stomach came up to my throat and I still am a bit teary eyed after reading about these possible changes. Dealing with insurance companies can be a big hassle maybe you could hire someone who only does insurance and pass that cost on to the patient. I am sure most insurance companies who approve this surgery do so because it is so much less expensive than any other surgery. Also, are your 1500 patients all persons who are pre ops? Perhaps packets should not be submitted until insurance is approved or patient decides to self-pay. I don't know about the clinic because I have not been to any yet. Is this really a necessary step? We already have physicals and bloodwork done. We can access info on line or even email you with questions. Perhaps you could mail out a video of the surgery with commentary for us to watch at home and then we could ask any questions via email/phone. We all want this so badly and we know you are only looking out for us. I am sure I speak for a lot of us when I say PICK ME!...Seriously, this is the most hope I have ever had with regards to this disease. I imagine you will be flooded with August surgery date requests. I know I may change my mind and try to get in in August instead of September if this change is really going to happen. I am afraid to wait till I can pay cash-I was so looking forward to " living " soon. I will watch closely for future posts regarding this subject... Best Regards, Donna Schanzenbacher Rapidan VA BMI 47 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 this will be this weekends hot topic. Dr. are the 1500 patients you have in the Database all pre-op? If they are, I see why you have to make changes. If you do 30 patients a week and plan on taking any vacation at all, ( I figured 4 weeks) assuming we all got approved, people submitting info today wouldn't get a date until this time next year. Is this a real scenerio? I can't imagine never having this surgery. I hired a lawyer and am still in the appeal process. What do you think your back log is now once a person has approval? All the insurance help in the world doesn't help our problem, you are only one man doing the best you can. Your data base has grown from 350 when I first went to clinic in February to over 1500. WOW. I hate to ask this but is there anybody or any other procdure you would recommed to those of us who may miss the opportunity to have you operate on us? Still an MGB hopeful - Rozycki, Denver, NC BMI 53 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2000 Report Share Posted July 28, 2000 Hi, Everyone that is in process now should be grandfathered in is what I think should be done. So you should be OK. 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 > 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 > > > > 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 > your site...now I feel bad!! We do need a cloning machine! There has to be > a way to work this all out to benefit Dr. R and us hopefuls! > Holly > 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 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: Re: Coming Changes > In a message dated 7/28/2000 4:28:56 PM Eastern Daylight Time, > dnjester@... writes: > > > > > 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. > > > Money isn't the issue..its his time and the time of the staff so how is this > going to cut down on patients? Gosh..I have turned 3 people this week on to > your site...now I feel bad!! We do need a cloning machine! There has to be > a way to work this all out to benefit Dr. R and us hopefuls! > Holly > > > > 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 Dear Dr. R, Wow! What a tough decision you have to make. I thought the patient letter alone was a good 'weed-out' process...LOL. (Just kiddin') If I had it to do all over again and the insurance is a really difficult part of Debbie and Barbara's job, this would be my suggestion: When a patient fills out the online form, if the information gathered would continue to be put into a form letter as the ones that are sent to us in copy are, the patient would be responsible for sending the information to the insurance company. In the end with me that is what I ultimately had to do anyway. I was happy that I had a copy to fax to my insurance company. (I think it ended up being about 5 or 6 times until they finally got the info!) I know that I couldn't afford to have this done if I were self-pay. I also agree with what someone else stated and find someone else like you, (pass the torch) that you could teach to do this surgery. I know someone had to teach Fred Astaire to dance. Maybe you will get a " Ginger " in the process...smile. (No offense, Mrs. Dr. R.!) I would travel all over again to NC but it would be nice if some surgeons were closer to home.) Love, T. MGB 7/19/00 > > > 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...
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