Love my surgeon, hate his office

[majorsmama 91]

This post is really just a vent, but I'm posting it here because nobody in my life understands how frustrating this has been.

Last week I completed the final appointment for my medically supervised weight loss. It was not a great month for me for many reasons, but I managed to weigh EXACTLY the same that I did the month prior. When I mentioned to the nurse that I was happy that I hadn't gained, she said "yeah its a good thing too because we would have made you do another month.". I was taken aback and asked if she was serious and she said yes, that they've had insurance companies deny requests for even a .2 lb gain and so they've adopted the policy that they automatically extend the medically supervised weight loss by one visit. The thing is, since my first appointment, I had lost 29 lbs. So had I had even the smallest gain for one month, they would have made me come back another month. Despite the fact that MY insurance would not have required it. Also, my surgeons office made me have 4 total appointments even though Aetna only required 3. When I told my surgeons office that, they said "well we can submit after the third if that's what you want, but we won't help you with an appeal if you're declined". So they basically bullied me into doing one more visit than what my insurance required. And when I asked why it was their policy to require more visits than my insurance did, nobody could give me a straight answer.

I'm just so frustrated. If I weren't this far into the process, I would probably switch surgeons. My surgeon himself is fantastic. But the people who work for him are awful and the policies that his office have implemented are ridiculous. I think once my surgery is over, I'm going to give some overdue feedback. I don't want to complain now because I don't want to do anything to jeopardize my surgery. And this is a center of excellence too!

Edited May 17, 2015 by majorsmama

[AvaFern 3,516]

If you had posted this during the beginning of the approval process, I would have told you to let those people have it. I've worked in the medical field and patients that can be pushed around are pushed around because a lot of people who work in medical offices, not the doctors, PA's or people with actual medical education, have a minimal education and are exceptionally lazy. If someone is rude to you, you call them out on it right that moment. If someone wants to push BS policies like these, you explain to them that your insurance does not require that procedure and if they are going to insist on following arbitrary rules that are not required, you will absolutely go elsewhere. You are not just the patient, you are the customer....if they don't treat you the way you deserve to be treated, you let them know you have no tolerance for it, and you walk away.

I have a doctor (not my sleeve surgeon- he was a tool) that I love and who has largely very competent people. A few of his front desk girls though are complete idiots, so instead of dealing with them, I just ask to speak to someone who is competent or I tell them to have my doctor call me. If someone can't do their job, I will happily bypass them and let their boss know exactly why I didn't bother going through his little chain of dummies.

That being said...you're so close to approval, let it go until after surgery. In the end you are getting what you want and after surgery you can write them a very long, detailed letter and potentially a review online that should allow them to revise their procedures and their behavior.

[majorsmama 91]

I completely agree and thanks for the feedback. I so badly wanted to give that nurse a piece of my mind (it didn't help that she was completely unfriendly and rude that day) but I don't want to piss anyone off at this point. I'm just too close.

[nikkimapr 177]

Not fond of my surgical office either. Can't really say about my surgeon as I have only physically seen him twice since I started this in January. If I never asked questions I would have been longer in process because 1st doc failed to mention EGD procedure that was required, then the finance lady so worried about telling me what I will owe forgot to explain psych eval, didn't give me list of approved psych professionals, I just happened to ask one day about it. 3rd after EGD results weren't reviewed with me and it wasn't mention at anytime about also having surgery to remove hernia also. I got my sleeve approval letter along with denial letter for a hernia surgery. Called doc office and asked what is that about, they were like oh yeah nurse should have called you and went over, nope. The front desk and check out staff rarely speak, and don't give me warm fuzzies. But since I already started process I wasn't going to start over. Live in a bigger city and this office feels like they just cattle you through process. I understand your frustration

[CheleLynn45 615]

WOW.....I am so sorry to read these posts. My surgeon is great, but he is after all a surgeon so he is pretty much straight to the point and no sugar coating. He has always answered my questions and I have never felt rushed.

Now the office staff, coordinators and NP's I really really like. We also have a woman named Gayle who teaches the 2 hr+ post op class. She is fantastic and has had the sleeve surgery herself. For most of my follow ups I have seen the NP, Deb, and I really like her. She takes all the time you want, really goes over everything and has been available to answer my questions.

I am now in the process of having my ventral hernia removed by my bariatric surgeon and am dealing other staff member for scheduling and processing. Even these ladies have been great, especially with helping me fill out my paperwork for my LOA from work.

@majorsmama I hope you get your approval and scheduled soon! Good luck!!

[so excited and so scared 4]

I love my office staff. If the surgeon is as good as they are I'm gonna ace this!

[jas84047 72]

OMG You read my mind! I was just coming to post something exactly like this!

My surgeon's office is horrible! They do not return phone calls and IF they do they take days. They say they'd rather have emails but then when the reply they are snippy and rude. I had the worst time with the insurance lady and have been waiting over a week after my insurance authorization to get my surgery scheduled!

I like what I've met so far of my surgeon (only one initial visit a year ago) but his staff is seriously making me feel like I should look elsewhere but like you I'm so far into this that I just don't want to do that.

[SleeveandRNYchica 1,155]

I totally get it! The bariatric coordinator at my office took almost a month to get back with me regarding insurance requirements. I am a revision patient. I already knew what I needed to do. I could be on month two of medically supervised weight loss. I was so irritated! Thank goodness for the patient coordinator. She helped me get to the other coordinator. I think some of the people are insensitive to an already sensitive, emotional situation.

[majorsmama 91]

@@jas84047 sounds like we have the same office! Mine also prefers email because they do not answer the phone. So I email and it often takes days to hear back. At my final weigh in appt the insurance coordinator told me she would review my info and email me with what (if anything) she still needs but would email me regardless. Yeah, that was almost a week ago and no email.

[lillyD 7]

REVISION (pre)- the nurse for K.Hollis required I be on a liquid diet for 1 week for insurance purposes. I gained 2.6lbs after they unfilled me. I do need to call the insurance myself you know GO OVER HER HOMEWORK TO SEE IF office is jackin w me or is this FA real.i started out w/ A lap-band @ 220.. Then kept looking for easy food to eat cause of all the vomiting issues 5years later I weighed 231.? And now on 4th day liquids and I'm 225.4 at wt in 4days ago I was 228 and the receptionist read aloud the notes they wanted me down to 220lbs before they submit to my insurance PHCS - ALLIED..

Anybody got those insurance?

I just want a price what's my 20% gonna be either way if insurance don't do this for me. I'll pay for it cash. I was thinkin maybe this June If get an answer but it take 2-3 weeks after a submission the nurse said. Lookin maybe July sheeshhh idk.

[bikrchk 1,313]

So I GAINED 10 pounds on my 6 month diet. I was close to the BMI limit and couldn't have lost and still qualified. Plus I had recently been prescribed a statin med that exacerbated weight gain. BCBS of KC approved me in 10 days. It's NOT impossible. I did manage to take off the 10 required plus interest for the doc's required liver shrink the month before surgery once they'd taken me off the statin in prep for surgery. His office staff (one in particular) was AWFUL but Doc was AWESOME! I can say I was completely honest about the good and the bad when it came to survey time!