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It All Fell Apart Today... Surgeon Left Practice!

This is the beginning of my 5th month of my 6 month pre-surgery diet/observation time and I was suppose to meet again with my surgeon today. I received a phone call late Friday telling me the appt had been canceled and I needed to call the office on Monday.

Called today and it seems that my surgeon (the only one in this practice) has decided to leave to join another practice. He will no longer be in network for me or be able to perform surgeries at the hospital I need to use for my insurance. I was expected to have surgery late next month or sometime in December.

I got on the phone with my insurance and after checking with all the surgeons they have listed there isn't anyone that performs this surgery at the hospital I have to use. My husband works for an HCA owned hospital so we have to have all our hospital stuff done at an HCA owned hospital.

There is ONE option, but it's a long shot. There is a very well respected surgeon in town that performs this surgery at the hospital I needed, but he isn't in network. I've made a formal request to the insurance to see if they will make an exception and pay him as in network. I'm not sure how long it will take them to make this decision, and I'm not sure how likely it is to happen.

I'm grieving today. I had a lot of plans and hopes for my new year. I wanted to have this surgery before I started 2013, and now I'm not even sure it's ever going to happen, but I know for sure it won't happen this year. It's been a very hard day.

-K

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This is the beginning of my 5th month of my 6 month pre-surgery diet/observation time and I was suppose to meet again with my surgeon today. I received a phone call late Friday telling me the appt had been canceled and I needed to call the office on Monday.

Called today and it seems that my surgeon (the only one in this practice) has decided to leave to join another practice. He will no longer be in network for me or be able to perform surgeries at the hospital I need to use for my insurance. I was expected to have surgery late next month or sometime in December.

I got on the phone with my insurance and after checking with all the surgeons they have listed there isn't anyone that performs this surgery at the hospital I have to use. My husband works for an HCA owned hospital so we have to have all our hospital stuff done at an HCA owned hospital.

There is ONE option' date=' but it's a long shot. There is a very well respected surgeon in town that performs this surgery at the hospital I needed, but he isn't in network. I've made a formal request to the insurance to see if they will make an exception and pay him as in network. I'm not sure how long it will take them to make this decision, and I'm not sure how likely it is to happen.

I'm grieving today. I had a lot of plans and hopes for my new year. I wanted to have this surgery before I started 2013, and now I'm not even sure it's ever going to happen, but I know for sure it won't happen this year. It's been a very hard day.

-K[/quote']

I'm so sorry to hear that. I wish you all the best and be patient things happen for a reason!

Wow. I am sorry to hear this...so close and things change. I like to believe things happen for a reason, yet I know this statement most time is no immediate consolation.

Are you able to check with the new surgeon's office as well to see if he could bill you under your network, since the hospital is in network? Or agree to accept payment as an in-network patient? I don't know and may be grasping at straws? But nothing beats a failure but a try.

Keep your head up StrongMommy

Have you considered going to a different city to have the surgery? Maybe there is an in-network doctor and an in-network hospital in another city not too far away. I live in Houston so there are plenty of in-network doctors. Lots of people come to Houston from as far away as Beaumont or Victoria (125 miles away) to have surgery. I see you are in Norman, OK. How far is that from Dallas? Or Tulsa?

This is the beginning of my 5th month of my 6 month pre-surgery diet/observation time and I was suppose to meet again with my surgeon today. I received a phone call late Friday telling me the appt had been canceled and I needed to call the office on Monday.

Called today and it seems that my surgeon (the only one in this practice) has decided to leave to join another practice. He will no longer be in network for me or be able to perform surgeries at the hospital I need to use for my insurance. I was expected to have surgery late next month or sometime in December.

I got on the phone with my insurance and after checking with all the surgeons they have listed there isn't anyone that performs this surgery at the hospital I have to use. My husband works for an HCA owned hospital so we have to have all our hospital stuff done at an HCA owned hospital.

There is ONE option' date=' but it's a long shot. There is a very well respected surgeon in town that performs this surgery at the hospital I needed, but he isn't in network. I've made a formal request to the insurance to see if they will make an exception and pay him as in network. I'm not sure how long it will take them to make this decision, and I'm not sure how likely it is to happen.

I'm grieving today. I had a lot of plans and hopes for my new year. I wanted to have this surgery before I started 2013, and now I'm not even sure it's ever going to happen, but I know for sure it won't happen this year. It's been a very hard day.

-K[/quote']

Hugs to you! This is not happy news :( I hope it all works out for you and get the insurance to pa in network!

I can't imagine the turmoil. Prayers are going up for everything to work out in your favor.

Wow. I am sorry to hear this...so close and things change. I like to believe things happen for a reason, yet I know this statement most time is no immediate consolation.

Are you able to check with the new surgeon's office as well to see if he could bill you under your network, since the hospital is in network? Or agree to accept payment as an in-network patient? I don't know and may be grasping at straws? But nothing beats a failure but a try.

Keep your head up StrongMommy

These would have been my suggestions as well. I have definitely heard of insurances waving the In Network policy if there are not any others in the area that perform that surgery/service. Maybe it's not as much as a long shot as you might think??? Don't give up!

  • Author

Thank you everyone.

The next closest hospital for me would be in Dallas. Doing the 6 month stuff with a dr so far away seems overwhelming to me right now. I have a 2 yr old and a 3 yr old, and being gone anytime if difficult.

If they don't approve this surgeon and/or if this surgeon won't accept being in network (he doesn't have to agree to accept that amt) than ill have to think about my next step.

I'm trying to focus on the statement that all things happen for a reason and maybe I'm not ready yet. I haven't been able to focus on a diet in this 6 months and I've been struggling with binging.

Has your husband tried talking to his human resource office to get help with this matter?

I am using Dr. Jason Harrison he accepts almost all insurance and is in Arlington. Not sure if you said where you live not sure if he is closer or further from you.

Having mine done at HCA sorry forgot to include that

  • Author

Thank you Bmarion662. I'll check into him if I can't get this other doctor to work out. I'm in Norman, OK so Arlington would still be a drive for me, but it would be better than not having the surgery at all.

What HCA hospital are you having your surgery?

The insurance might take the 5 months you have already done and apply it to your requirement, if you can produce all your records. You have done all the work. Did they tell you that you needed to start all over? Might be worth a call to a supervisor.

Good Luck!!

Sorry to hear that!!!! Stay strong and dedicated. Try changing your health insurance call and see which ones don't provide for your to get on a diet for that long.

His office is actually in the HCA off Matlock and I20 in Arlington. Not sure what your insurance is but you can check him online. I have Aetna

He is really honest about the surgery and does not hype it up to be the greatest thing in the world to boost his practice the office staff is very personal and never have automated systems

Thank you everyone.

The next closest hospital for me would be in Dallas. Doing the 6 month stuff with a dr so far away seems overwhelming to me right now. I have a 2 yr old and a 3 yr old, and being gone anytime if difficult.

If they don't approve this surgeon and/or if this surgeon won't accept being in network (he doesn't have to agree to accept that amt) than ill have to think about my next step.

I'm trying to focus on the statement that all things happen for a reason and maybe I'm not ready yet. I haven't been able to focus on a diet in this 6 months and I've been struggling with binging.

Most insurance will accept if you do the 6 month NUT in your home town - I've heard of them accepting medifast or with a nutritionist in your home town. You could do the preliminary required testing in OK City and have the surgery with a physician in Dallas. They could have you do the follow-ups with your PCP in Oklahoma City.

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