Guest guest Posted July 29, 2000 Report Share Posted July 29, 2000 Dr R~ Indeed, this is a very difficult issue. While I respect your feelings of being overwhelmed and perhaps feeling a tad bit " buried " , I do appreciate your concern that you may not be able to give all of these patients the attention you feel that they deserve. And you have come to the most likely group that will be able to help you----patients who have gone through the process and know where the excess work exists for your office. Correct me if I'm wrong, but this is how I went through the process......(and I've seen this happen to others too) is I visited the site while doing research----not really having made a decision to have this particular surgery---although of course it was definitely my procedure of choice after completing my research---while there, I was invited to fill out the online form. It asked insurance information, etc.......I had no idea that an insurance application would be filled out and submitted at that time from doing this; I just thought it was used IN CASE I decided upon this procedure. I think it would save the office alot of paperwork if you screened patients for eligibility BEFORE they ever got to that point. Perhaps instead of an insurance form you could post a patient interview that could be read and a decision on whether or not to take the patient could be made from the results. Then you can email the patient the URL for the online form and the insurance could be contacted at that point--or perhaps require them to attend clinic first before filing anything with anybody. OR you could leave it up to the patient and their PCP to file the claim for insurance. Some people get approved right away, some people have to go through an appeal. Doesn't seem to make any difference who files the letter, many patients fare just as well with their own or PCP's insurance appeal letters (who knows the patients better), some fare even better. By now you know that some insurance companies have heard your name many times, and they have commented on the fact that the appeal letter is the same only the morbidities change. Which if fine, I mean, that's exactly what I would do in your case, it would be a formidable task to type a personal letter for every patient. But perhaps for an appeal, it would be better left to the patient, and maybe perhaps offer a small " canned " letter stating your support and acceptance of the patient which bore your signature that the patient could use, but make available all the other data in downloadable/printable form from the website that we could choose and use at our discretion. I did find the pages about mortality rates and obesity quite helpful, and I'm sure if you just made these pages available on the website, we could be responsible for organizing this data and filing our own appeals. So, other than minimal insurance support, suppose you just let the patient handle their own insurance hassles, and the office can just sit back and wait for the insurance approval letters to come in. Give the insurance responsibility back to the patients. And if they don't know how, then they better learn. You have many well-educated patients---we could not be your patients if we weren't. We can figure out how to cross our t's and dot our i's with the insurance, you just take care of us, that is what we want you to do. I do think that accepting only self-pays, only reserves your surgery for the (mildly) wealthy, while if most of us only kicked our insurance companies in the rear we can get what we want out of them. I do hope if you make this decision, that you grandfather your patients that have been with you for awhile into the mix. I have been vying for this surgery since Jan, I had clinic Feb 19th, and have been fighting with insurance with my HR dept's help since then. They told me only yesterday that they will definitely have a decision by the end of August. I hope I haven't gone through all of this waiting and fretting only to be told it was for naught. So leave the insurance in our hands. I can tell you after having been in Healthcare for 20 years that I was amazed that you help with insurance as much as you do. Give it back to us, and we can take it and run with it. You just make sure we are well-informed about the procedure (and you do a wonderful job) and that we have all our ducks in a row (which we will when we get there). I hope to be on your dance card sometime in Sept.----and you know, many bariatric surgeons have waiting lists of a couple of months......what's wrong with that? Pace yourself.....only schedule 4-6 surgeries on your days, just schedule them farther in advance. Let the list of patients expand, dont' worry about them during the insurance process, just handle the cases you can handle each day. Perhaps some day there will be some doctors who will pull their heads out of.....I mean be able to help you with all of your work. And all the other stuff?.....fuhgeddaboutit.LOL A humble (old) patient who has been lurking..... FG > Date: Fri, 28 Jul 2000 13:50:39 -0400 > >Subject: 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@... > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 29, 2000 Report Share Posted July 29, 2000 This is a very good idea. Let us do it. This is a smart group and those that don't know how to do something can use the site like we always do when we need to know something. The insurance will be handled by us, and it may help to have someone to just do the scheduling. You just schedule only a certain amount of surgeries per day. None of us got this way in a month or so. If a push comes to a shove, we can wait. Especially if it means preserving our doctor. I was thinking just last night, if anything happens to Dr R. we are all up the creek without a paddle. May God bless you is my prayer. (waiting to start a new life) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 30, 2000 Report Share Posted July 30, 2000 Well said. I think screening patients initially instead of waiting for insurance information and the packet to be mailed in would be a great idea. I think it would save alot of people from getting their hopes up for months. 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@... > > > > > > > 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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