Jump to content
×
Are you looking for the BariatricPal Store? Go now!

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



Recommended Posts

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

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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?

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

Having mine done at HCA sorry forgot to include that

Share this post


Link to post
Share on other sites

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?

Share this post


Link to post
Share on other sites

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!!

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×