Dr. De La Cruz and hospital contract? HELP!

OK, heres my dilema.  I've jumped every hoop, done all the appointments and just have done all that is asked of me.  Last I hear, UHC and the hospital (Mount Sinai) my doctor worked with that health plan no longer have a contract.  According to the office staff, by mid-March a new contract should be resolved with UHC and Hialeah hospital I guess.  Anyhow, someone recently mentioned to me in another post I had posted a while back about playing the waiting game that they had originally considered my doctor, but that she got the same run around about the insurance company and a contract.  I'm wondering if there are other patients out there...maybe he doesn't like doing revisions.  I'm going from Lap-Band to RNY.  Did I make a mistake choosing him?  From my research, he seemed the best.  I need to know if someone else out there had the same run around and decided on another doctor.  Please help. -Maria

Maria, Two of my friends both husband and wife had Del La  A Cruz Nunez and they were very happy with him!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

FLGail, I know a few people who have had the surgery with him as well.  That's not my problem, I picked him because he's the best in Miami.  My thing is I don't know if I'm getting the run around about my insurance not having a contract with the hospital or what because what I am having done is a revision.  I have UnitedHealthcare and they cover EVERYTHING, so it's concerning me that there is an "issue" with the contract.

I am scheduled for RNY with Dr. De la Cruz  on March 19th in Mount Sinai. I personally picked him because through all my research he really was the best. In all of Miami I would only trust my self with him or Sosa. but de la cruz is my first choice GL

Hi Aphrodites, Did your insurance cover it?  And if so, how fast was it approved? Smiley 777

Sorry unfortuntely my insurance had an exclusion for wls. So I am having to pay everything out of pocket. If there is anything else I could help you with just let  me know.  Thanks,

Hi Aphrodites, I'm wondering if you or anyone else can help. I have someone that wants to help me pay for the WLS since my insurance doesn't cover it but they are asking me to find out how much an insurance company would pay. Apparantely insurance companies manage to pay much less than a regular self pay. Does anyone know how I can get this info?  Also, is Dr de la Cruz considered the top surgeon in Miami?  Thanks - Cory

Hi Cory, From what I know it's actually the other way around. When a patient is self pay usually the office will work with the patient to either lower the price of the surgeon or help out with a payment plan. Either way Dr. de la Cruz is one of the best priced doctor's overall. Generally the surgery cost 30k average and to be 2 nights at Mt. Sinai with a private room it's only $17,500. His follow ups are free as long as you go to the support meetings (aftercare is very important to him so he does this as an incentive) Personally he is the best doctor, I wouldn't trust myself with anyone else.  In reality there are only like 3 center of excellence's in south florida. On in miami (dr dela cruz) another in homestead and I think the other is in weston. Other then that it's just other doctors who have no interest in becoming a center of excellence or don't qualify. Good Luck!

Thanks for the info. Right now I have to get 2 more quotes for the surgery so that the person can compare. I agree with you regarding Dr. de la Cruz, I just received a quote for Cleveland Clinic and self pay is $29k for the gastric bypass.  Hopefully I can gather all the info today. Do you have the name of the doctor in Homestead? Thanks- Cory

Well good luck with your quotes. I believe the center of excellence in Homestead is Dr. Sosa. I know the other Johanna (aka johy) just had her surgery with him about 3 weeks ago. You can probably ask her for more details.  Let me know if you end up going to de la cruz. We can form a littlle de la cruz clique lol  Anyways GL