Re: accepting insurance

[Guest guest]

>I think your idea of accepting only self-pay patients is a good one. It

>would probably eliminate about 90% of the patient load and from the

>sounds of it, that is what needs to happen.

Yes, but this is only a good idea in theory.......While Dr R is a stupendous

surgeon, his surgery is not without risks. I for one would PREFER to not go

under the knife without knowing that I am covered by insurance in case I

have to spend days in ICU or have to have another surgery.

>

>However, while many people would be able to pay the $4000 surgery fee,

>that still leaves the hospital and anesthesia that have to be

> " pre-certified " by insurance (somebody has to do that . . .) or else

>patients will be paying about $14,000 themselves up front. I think

>there are probably plenty of people who can come up with $4,000, but

>$14,000?

It would be $100,000 if you had surgery and had complications..........

>

>> You could weed out the less serious patients in the database and

>>let the serious ones proceed.

I think the " less serious " or " thinking about it " patients need to be held

back from filing insurance until they have made their decision---or make the

patient do their own research to find out if their insurance carrier

supports WLS or what they have to do on their own to get it approved.

>I think it would be a mistake for Dr. Rutledge to take the more serious

>obesity cases, such as revisions of RNY's, people over 350, people with

>a predisposition to have complications for one reason or another,

>because it is likely to skew the complication rate and safety statistics

>dramatically and it would not be a true reflection of the actual safety

>of the procedure for the average patient.

I agree, he should be able to take patients who fall within his particular

guidelines. He has stated that he does not do patients over 350 or previous

WLS cases unless he has counseled with the patient beforehand.

>

>Additionally, while we are worried about allocating a scarce resource

>(Dr. Rutledge's surgical expertise) why should he spend 4 hours on

>one-patient, to reverse an RNY or fight scar tissue from a previous

>procedure, when he can do 7-8 normal MGB patients in that same time?

A truism.....when I signed onto the website I was to understand that you

were excluded from surgery if you had previous open abdominal surgery. Dr R

being as talented as he is performed surgery on many who had complicated

adhesions from previous surgeries (including prior WLS). Perhaps he needs

to reset his criteria back the way it was before. Temporarily restrict

surgery for those who have risks of serious adhesion problems from previous

surgery.

fg

[Guest guest]

I know that something needs to be done. I think the cutoff date of Angust 1 is

a good tdea. It will allow those who have been working so hard to finish up and

get in.

I can't really say that I think the idea of accepting ONLY self pay patients

would be fair. No matter how bad you want it or how serious you are ...bottom

line is most can't afford to self pay. You can't just go out and FIND the money.

And thats not a very fair way to solve htis problem.

The best suggestion I have heard is to charge for insurance filing and maybe

hire someone to do only this.

For the patient backload. Stop taking patient forms on Sept 1 and catch up on

who you have already.

JMO