Weight Loss Surgery Dilemna

I need HELP!!  I have been in the Bariatric Weight Loss Program with Moore Regional Hospital, Pinehurst, N.C. under Dr. Kenneth Mitchell beginning in November of 2007.  Two weeks ago when I asked co-ordinator about what time frame for scheduling the surgery (Rhoune-Y Gastric By-pass) she told me "you know your Insurance provider is OUT-OF-NETWORK and in order to schedule surgery you will need to pay Dr. Mitchell in FULL prior to surgery date.  I had asked on many occasions about my Insurance coverage etc...they said "everything is fine, we will do all the filing etc.. for you".  Needless to say I do not have $11,000-$12,000 to come out of pocket; I dropped out of the program, they refunded my $250 administration fee after several conversations...Now after 3 meetings with representatives from Oxford Health they have agreed to cover the procedure as "IN-NETWORK" because there is no other available surgeon within 45 minutes driving distance from my home.  I have completed  Cardiac testing, Psych. screening and testing, sleep apnea testing as directed by physician, now Dr. Mithcell's office will not communicate with me to get this going!  Any suggestions, Thanks!!  Marty B.

Keep calling the program co-ordinator. The info session and support group are tomorrow. You may be able to speak to someone in person. I know there are people involved in the process than when I had my surgery almost 2 years ago. But someone there Thursday may be someone able to point you in the right direction. The info session starts at 6:00PM at the Moore Regional conferance room. B

Be peristant. Remember they are there to help you and work for you.

 Good luck hon!

 

 

I'm one of Dr. Mitchell's patients. Have you spoke with Carolyn? She has been very quick to return my calls over financial issues.  If you haven't, I would call and ask for her specifically - or Tina.  I would make sure you have something documented from the insurance company you can give/ send them.  Sadly, I had seen 3 doctors prior to Dr. Mitchell. They are all like this. Even In-network patients have to pay some. Like my insurance is a 80/20. I had to pay the out of pocket 20% up front  The hospitals are the same too.  I can tell you this personally from watching him do it. If Dr. Mitchell found out himself? He'd be mad as all get out a patient wasn't getting contacted.  He really truly cares and I've heard him get stern with nurses and such who can't seem to "follow the program" the way he wants it for his patients.  Heck! I go on the 27th for my 6 month post op visit. PM me your information if you don't have someone call you back and I"ll tell Dr. Mitchell myself what is happening. LOL I lay wager, you'd get a call 20 min after I talked to him

Thanks for your reply.  Carolyn is who I have been dealing with. At first she was extremely helpfull but now I don't understand the change. I have left messages for Dr. Mitchell but not any response. I am very close to being on Kidney Dialysis and when I first met with Dr. Mitchell he was very anxious to get me started towards surgery.  Co-payment is not a problem, I have $5,000 or so to pay co-pay but not $11,000-$12,000.  Insurance company will pay 80% as well. I have spoke with Carolyn about speaking with my insurance company, she said "I'm too busy today but I will call tomorrow" that was Jan. 17,2007.  Insurance company wants the "CPT" Code & Diagnosis Code and date of surgery to pay IN-NEWORK.  Thanks for your advice and any help!!  Marty