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My surgeon won't operate because I complained

Unbelievable. After two years and three appeals I get approval and redo my tests, he tells me I will get a date in two weeks.

I call his office after my second round of tests and she tells me they are full for the rest of the year and I have to redo my tests for the third time.

She wasted my time and the insurance company money. She acted like it was my fault then informed me that she couldn't accept my approval letter because she had never seen one like it.

I was so upset. I was so emotional and raised my voice and she kept saying I should have known they didn't have any more openings and it was my fault.

I told her I was done and hung up and cried.

I decided to try again today with my insurance contact on the line. Same woman told me that because I complained to the hospital I am now too much of a risk and he won't operate on me. And won't give me my money back to join the practice.

  • Replies 42
  • Views 9.4k
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there is some sort of disconnect. I would speak to patient advocate and the head of surgical services. going to joint commission won't do anything. Definitely find a different provider

  • Author

I got an email today that they got my packet and assigned me to a coordinator. My old hospital didn't have coordinators.

Find another practice ASAP and call your patient advocate at your insurance company for help.

no kidding. I sure as heck wouldn't want them operating on me.

  • 2 weeks later...

Run, Run Run.. when a doctors office shows you this kind of treatment after all you have been through I would say it is time to find another practice, get better professional treatment. You are worth all the time and effort you take to change your life you dont need to be subjected to this.

  • Author

Thank you. I read on another thread that the hospital I'm looking into requires six months of dietician visits which I refuse to do.

I just do not understand how they don't get that you can have all the knowledge in the world but if you are hungry constantly you aren't going to lose weight.

If dieting worked I would have kept it off and not spent the last twenty years getting fatter and fatter.

I hear you on the dieting thing. My surgeon requires just a couple of weeks of a liquid diet with Vitamin supplements because he wants the stomach and liver to shrink before the surgery. It makes the surgery safer, and the stomach will be more healthy in its new, smaller size. Maybe your new surgeon will be able to do something like that for you.

If you have comorbidities, like hypertension, diabetes, sleep apnea, sometimes you can be put on what my insurance company calls the "fast track". That means just two weeks of the special diet rather than 6 months or a year. Makes sense to me!

The hospital that treated you so badly about the billing and scheduling should be addressed first to the hospital administrator. You might also contact a social worker, if they have one.

Hope this helps!

  • Author

Thanks. I contacted the hospital and they said every one has a different experience based on their insurance.

I did weight watchers for 9 months and lost about forty pounds but then I plateaued and they acted like it was my fault. A couple of things that were said in meetings made me really uncomfortable. I felt like I was seen as a failure while people who only needed to lose 20 pounds were treated like heroes.

Then I decided to look into surgery. The bariatric program called UHC and they said I didn't have to do a six month diet. I was buying a house and decided to wait until we moved and got settled to have surgery.

So six months later I did all the testing and they submitted to my insurance but then the insurance co said I needed to do 6 months of a diet plan.

Then I spent a year trying to get weight watchers to provide me with proof, and appealing over and over and being told something different every time I called. Yes, Weight Watchers is acceptable. No it isn't. Well it is if a doctor is monitoring you. Well no it isn't. Well it is but the letter from Weight Watchers doesn't say what we want it to say.

It was a nightmare.

I just really hope this goes quickly.

Ever consider self pay in Mexico? You could be two years post op and at goal by now. And you would be treated a heck of a lot better than you have been so far.

  • Author

Ever consider self pay in Mexico? You could be two years post op and at goal by now. And you would be treated a heck of a lot better than you have been so far.

I dont have good credit and we don't have the money for it. I don't know what else to do. I'm also scared of having surgery alone so far from home.

Edited by Loveit2012

  • 1 month later...

Try calling the state insurance commissioner and file a formal written complaint. Also, be sure to go to Healthgrades and write up a review.

I'm in the hospital now, had surgery yesterday. I'm so glad I switched!

So glad you switched too...that was horrible how they treated you. Did anyone ever call you back after going to the joint commission?

Yep I've had the same thing with Sentara Comprehensive Weight Loss Center, but the issue was more on not recognizing complications, nutrition not being followed nor worked with, records were a problem. The attitude there, someone once stated (in a nutshell) that if you were "easy pickings" then it was fine, but if there were problems, they would dump you.

I am starting to post my records excerpts online at bariatrichelp.wordpress.com and getting together hints/tips so people can look through and make decisions before they get into a program. I'll be adding more.

Once people see the records, its quite an eye opener. If you want to see a tough case, and how things are handled, I'm a poster child for that. I don't want people to suffer the same things I did, and maybe giving them my experiences and what doctors have helped me would help others have an easier time.

One of the examples is that in November 2012 my urgent care PCP believed I had neuropathies by malnutrition (which I was diagnosed with after the surgery). The plastic surgeon said the same thing in Jan. The bariatric surgeon didn't. However, things have grown progressively worse and they're all saying nutrition. The medical literature indicates that this can be an issue of bariatric surgery, but the surgeon never picked up on it but an urgent care FP was the first one to figure it out.

I've gotten flak for pointing it out but the facts are there in my records and medical literature.

Vic

Edited by swimbikerun

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