Dr Samuel Cox Redux

Dr Cox is no longer listed as a Medicaid provider on the Florida Dept. of Health (DOH) website http://ww2.doh.state.fl.us/irm00Profiling/profile.asp?LicId=73839&ProfNBR=1501&External=TRUE. For those of us (some 50 or so) who have been told to "just wait...be patient" over the past year, this is more proof, IMO, that it's just not going to happen. in order to get the entire link, you might have to copy and paste it into your browser.

Trish- I looked at the link and the listing says "The practitioner did not indicate if he/she participates in the Medicaid program. " to me that says that Dr. Cox did not say whether or not he participates in the medicaid program. That is a lot different from saying he does not participate. I do not think you can draw any conclusions from the listing. What does Dr. Cox have to say about it. Red

Hi Red, lmao - I post and it changes - just like that! That's not the ony thing that changed... let's see.... his Staff Privileges have changed too. Looks like someone has done some updating. Funny that I can't get return calls from Dr Cox or Deborah for the past 10 or so months, and one little well-placed factoid on the Florida board causes a mini-flurry of activity. Dr Cox has nothing to say about it, as far as I know. He received my numerous requests for return calls - unless Cary is not relaying them - I wouldn't be surprised. That said, Medicaid approved me for surgery w/Dr Cox last October. He has my phone number. I'm still waiting..........

Trish- What did it say before. I know you have been waiting to have your surgery for a long time and there has been so sort of controversy. I thought it was between the doctor and the hospital or something. I do not know Dr. Cox although I do remember he was a tremendous help to some folks on the board last year. Is there another surgeon you can use? Red

Hi Red, It said something short and sweet, like, "Not a Medicaid provider." I wish I had kept a copy, but my detractors would probably say I could easily change a copy, and they would be right. I think I am the one who has been kicking up most of the ruckus about this situation. I have called Dr Cox's office at least once a month, and sometimes once a week. I almost always get Cary when I call, and he tells a lot of amazing and conflicting stories (to me), sometimes cramming 2 or more into one sentence. I relayed some of his stories on the message board, along with whatever facts I could gather, and sometimes comments or questions from emails I get from people like me... waiting for surgery and getting the runaround. The truth is something I've come to believe I'll never know. People who get mad at me seem to think I'm dissing Dr Cox. I really think a lot of the confusion results from Cary, and I wonder if Dr Cox, and/or Deborah, know what we are being told or how we are being treated. Letters and phone calls go through Cary. I believe it is possible that many of us (Cary says there are 50 Medicaid pts. awaiting surgery) are afraid to speak up about this for fear that, when whatever-it-is-that-is-wrong is made right, they won't get their surgery if they come forward with their concerns. I haven't called in a while due to the fact that being assertive and proactive have gotten me precisely nowhere. My last phone call ended w/me in tears because Cary 'went off' on me. I don't know why I stayed on the phone and listened to every bit of his abuse, whi*****luded a fair amount of name-calling. I guess I was just hoping to get a word in edgewise, but he hung up on me. Sounds crazy, right? It was! He has also, in the past, spoken to another patient about my patient information. When I asked him about it, he actually admitted it! I apologize for going on here... I could go on and on, but to answer your last question, I am always looking for another surgeon, but have not found one yet that accepts Medicaid/Medipass. Take care, Trish

Trish- That is really a shame, I hope you are able to either get get it straightened out soon or find another surgeon. Won't medicaid help you find a surgeon? After all, they have approved the surgery. I believe it is called a de facto denial to approve a procedure only to have no one in the network to do it. If after all this time they cannot help you find someone to do the surgery in network they should grant you out of network privileges. Because medicaid is a state program you might want to talk to your State Representative and to an attorney. You should always be treated with dignity and respect and any physicians office who does otherwise should be dropped from the program. Also it may be medicaid but even medicaid has rules and procedures. Soon it will be a year and by then your approval may expire, so now is the time to try to get things moving again. Good luck- Red

Thanks, Red, for your concern and support. You make some good points as well... good information. My efforts to resolve this through Medicaid haven't gotten me anywhere, so perhaps it is time to speak to a lawyer. I hadn't though about the possibility of my approval expiring. I really hope other patients of Dr Cox are reading this and finding your suggestions as helpful as I am. Take care, Trish

I'm so sorry about all the fuse about Dr. Cox. I'm on his waitng list. He is not a center of excellence therefore medicaid has not re newed his contract as of yet. I received a phone call from his office saying they were making a list to petition this. I had staywell in May,2006 before filing a greivance and switching to medipass. They gave me a Dr. Gomez in H (they called the last day ) Hialeah who was taking medicaid. I now am seeing Dr. Bass (almost time to send papers off to insurance). If you are having a hard time finding a surgeon. File a grievance call there coporate office. Trust me they will have 30 days to find you one. If not you can leave their HMO. They will do nothing but give you the run around if you dont put it in writing. I dont know much about this but what I can say I've gotten myself out of my plan before open enrollment.

Hi Cherina, I'm hate to admit I'm a bit confused... I have Medipass now. Do you think it would be beter for me to stay with Medipass, or try to force Medicaid to release me to one of the other plans now? I called Dr Bass this morning and was told they DO take out-of-towners now, but I have to go down and attend a seminar before they will give me any more information. Getting me from Tampa to Broward County is no small thing, so I'm really hoping this will bear fruit. I'm also hoping they will accept testing done last year and not make me take repeated trips to see their people. I paid $400.00 for Dr Cox's psychologist, plus nutritionist, hotel, and other out-of-pocket expenses.. $$ is really tight for me now. I got off the track there... sorry. Can you tell me who/where to call/write at Medicaid... or Medipass? Every time I call them I am passed around for hours at a time, and never get anything more than a new department, agency, etc. Good luck to you & thanks for your help, Trish

HI Trish, rememeber me? Glad to see you havent given up the fight. Im still there with ya, getting the run around. I even called Dr. Bass like you did and was told they dont take anyone over 50 miles out of thier area. They said they have too many locals needing the surgery. I heard about the surgeon in Miami but I sure dont wanna have to go that far if I can avoid it. But that might be out only option. Like you said, I dont really know how to get through to medicaid. When I call they say my pcp has to call and my pcp never seems to be able to make contact with the right person. Another bunch of BS. Anyway, just wanted to say Hi , good luck and If I get any good info I'll let ya know. If you do let me know. Its almost a year for me too. I hope our approval doesnt expire. Love and Peace, Mary (Krickett)