Help!!!!!!!

Has anyone on Medicare been scheduled for surgery for Dr. Jorge Rodriquez yet? The last I heard, they were waiting on approval from Medicare to be approved as a Center of Excellence. Has anyone else had this come up? Are there any other Medicare patients out there that are waiting on surgery. I was scheduled on February 24th and was cancelled due to Medicare Guidelines, I was told. The center was inspected on June 15th. The staff at the center told me that it COULD take up to 90 days to get approval. Well, September 15th will be the 90 days and I STILL have not heard anything from them. I guess they are going to take it to the full 90 days. They just don't know how hard this is on me. The waiting to get my life back, has been put on hold for over 7 months!!! I am an emotional eater too!! I have already gained another 20 lbs!!! When is it going to end? Someone please get back with me and let me know if they have medicare and when they are/were scheduled to have surgery at the Norton's Hospital in Louisville. The doctor's name is Dr. Jorge Rodriques @ the Norton's Bariatric Center. Please, someone, respond!!! I'm going out of my wits here! Thanks!

Hi Sharee, I am not a medicare patient but I am familiar with the COE situation. This guideline is set up through the American Sociiety of Bariatric Surgeons, a facility cannot perform bariatric surgery on a medicare patient, unless they are inspected and approved as a Center of Excellence. All of the centers are going through this right now since medicare made this decision. Dr. Rodriquez and his staff and or Norton has no say so n the matter. They are correct in telling you it takes 90 days, once it is official they can then set things in motion and unfortunately there is nothing they can do in the meantime. Medicare will not pay a dime for anything that would be done before the approval. I know the wait is long and its so difficult to go through, believe me I know for a fact the surgeons and centers are on the edge waiting to hear as well... My suggestion would be to wait until the Sept 15th date, if you have not heard from them by that time give the office a call. I had my surgery 3 yrs. ago, it took 6 months to get my approval and I just waited another 3 months for my plastic surgery approval, the wait is grueling but well worth it in the end. email me if I can help you in anyway.. Brenda

Brenda, Thanks so much for confirming that I made the right decision to wait it out. I just felt comfortable with Dr. Rodriquez and didn't really want anyone else to do my surgery, if possible. It IS so hard waiting though. I guess God is still working on my patience issues... ha ha I never have been good at sitting back and waiting. I'm one of those who go out and make things happen, you know? My weight is the only thing I have ever had a problem controlling. It's like it controls me!! And, it still is!! I already have written on my calendar to call them on the 15th. I'm sure they are getting tired of hearing from me....ha ha I try to call once a month -- since June 15th. Thanks for your response. It has given me a little more strength. I know it will all be worth it in the end. I just can't wait!!!! Obviously!! ha ha I see your face here a lot! I'm glad you are finally going to have your plastic surgery. You are going to love the way you look when you have healed. Be sure to put maderma on your scars AFTER they have healed shut. It makes a world of difference!! They will hardly show at all! Good Luck and best wishes to you! Sharee

Hello I had my sugery and I am a Medicade I don,t know if its the same but I had my sugery in March-06 but it took me almost a year to be approve. Kathy Lancaster

Kathy, Thanks for the reply. It looks like it will be about a year for me to get my surgery too. I first went to the doctor in November 2005. Surgery was scheduled in February 2006, but got cancelled, and I'm still waiting. I know Medicare and Medicaid are two totally different things. I know it's harder to get approved through Medicaid than Medicare. I'm glad you finally had your surgery. How are things going with you now? It's been, what, six months? I bet you are lots smaller now!! I would love to see a current picture of you. I get so excited when I see the before and after shots. It makes me think -- I'll get there! I just want my life back!! I can't wait to start fresh. I know the easy part if the surgery. The hard part comes later. But, I will do anything to get this weight off of me. I just feel so terrible and ache all over, all of the time, and it only gets worse. But, I know it is all about to change soon. I just have to keep telling myself that, and hearing it from other people who have been there helps too! Hope you are doing well, I can't wait to see your after picture! Sharee

Hi Sharee, Have you thought about a different hospital? I am a medicare patient and I am going to King's Daughter Hospital, in Ashland Ky. with Dr. Wheeler, they are a hospital of Excellence. Everythng is going fast, and the people and doctors are great there!

Yes, I have thought about it. I would say, "should I stay, or should I go?" Now, I've stayed so long that a few more days aren't going to hurt. ha ha If I'm not scheduled for surgery again when I call the 15th, I will most definitely be looking elsewhere. It's just that Dr. R is the best, and if there were any complications, I would want him to be there. He is the head of the trauma unit at one of the downtown hospitals. I know I will be in the best hands if he does my surgery. I just can't wait until the 15th to move on, in whatever direction. In the beginning it was like we were doing 90! Then we hit that brick wall, called Medicare. It was so quick it was kind of unbelievable. But, I try to say, "there's a reason for everything." So, there is a reason for me to have to wait. I just hope it's a good one!! It's like being on an emotional rollercoaster!! Well, thanks for your reply. I will keep your idea in mind too!

Hi Sharee, Last Sept I went to Norton, Dr Rodriquez was to be my doctor, I had all my test finished, they told me I would have my surgery by Jan. Then I got a call from them saying they had to get the Cert of Excellence. I called Saint Joe East, Dr Nighbert and went there in April, had surgery in June. Norton wouldnt give my money back, I am on Medicare to. The total cost out of pocket at St Joe was $590.00 You might want to give them a call. They treat you good. Hope this helps Blessings Amy

Amy, Thanks for letting me know this. It just seemed odd to me that they had to get the certificate. I mean, have they never operated on a Medicare patient? It is confusing--because you would think they would already have this. Is this something they have to update EVERY year? I have called Medicare and they don't know anything about it, and have nothing on their records to show that they have applied or been approved or anything. I am down enough already, having to wait all of these months. I don't know why I didn't go ahead and find another doctor back in February. I just wasn't thinking clearly and I was told I would get a call, which I though wouldn't be long. I called every month and got the same story every time. Then finally in June, Shelly Moore, Dr. Rod's assistant told me that they had just been inspected on June 15th. I will call them on the 15th of September. If I get the same story or some other excuse, I will probably try to get in to see Dr. Shina. But, another thing, when I talked to medicare and asked them which facilities in this area were approved, there were none!! So, I may have to go as far as Lexington. Where is St. Joe East? And, will I have to have all of the tests re-done, since it has been over 6 months? I'm so upset!!! I trusted these people, and I'm now hearing that you had the same problem last year! It sounds like they don't want to operate on Medicare patients or something, doesn't it? I'm wondering if I should even wait until the 15th now? I'm so upset about this!! But, I am SOOOO glad that you told me this!! I had my doubts but was trying to stay positive and wait. Now I don't know what to do. Can you e-mail me and give me the hospital and doctor information on the ones you used? I would really appreciate it. Thanks! Sharee

Sharee... I know this seems upsetting but as I said it's not anything the doctors or hospitals can control..you can move on to another facility that already has the COE..right now all hospitals are trying to get their inspection done because medicare passed this law stating they will allow the surgery only at COE facilities..so anyone who was operating on medicare patients previously had to stop immediately until the inspection was done and then the approval passed.. As I stated before, this is upsetting to the facilities as well...the inspectors are trying their best to get every facililty applying approved as quickly as possible... I am not sure who you spoke to at the medicare office but they evidently had no idea what they were talking about...it is true that they must have a COE or they cannot operate on medicare patients.. I only want you to understand what is happening...if you do move on to another facility you will have to start the process at their facility from the beginning..chances are by the time you go through the testing and paper work your surgery date will not be any sooner. I am sorry you are stressed about this the waiting is always difficult..I have a good friend who is in the same position but she has chosen Dr. Sonnanstine in Florence, Ky to do her surgery...but again he was just inspected and we have to wait for the 90 days there as well.. I hope this helps a little anyway. Please feel free to email me with any questions you may have. Brenda