Question:
This is not a question, rather a warning to those having WLS.
I just want to warn others that there are doctors out there that think they can take advantage of those seeking WLS. Recently, I had such an experience. I was refered to Dr. Brightwell in Columbus Georgia for VBG. At my first appointment he said that I was not a candidate because my BMI was 36, I am 5'8" and weigh 237. He did say that if I was truly interested that he would write the letter for approval. I did get approved in two short weeks. So, we started making all the appointments for pre-op testing. Around that same time the office manager/wife told me that I would need to put up a deposit of $600.00 and that I would need to sign a "Waiver of Fees", well this sounded fishy to me. Luckily, the customer service person from BCBS called to make sure that I had everything in order. I then explained what the doctor's wife said and she said that I should not sign anything that he has a contract and that he must abide by that contract. Well, I was not exactly sure what she meant by the "waiver of fees" so the next day I went by the office to pick up some other forms and also pick up the waiver. What they wanted me to sign was a legal document that would guarntee him his full fee. I was to be responsible for whatever the insurance company did not pay. I came home, called the insurance company, then faxed them a copy of his waiver. They called and told me that I would have to call the doctor and refuse to sign the waiver and refuse to pay a deposit that was greater than my co-pay. I called the doctor's office and did just that, thier reply was "that was their policy and they were not changing it for me" I told her to cancel everthing and she said okay. I then called the insurance company and told them that they were not willing to change their policy. So BCBS took it from that point, they contacted the doctor and reminded him of his contract, of course his wife told the insurance company that I would not have to sign the waiver and that they would work with me on the deposit. I told the insurance company that there was no way that I would put my life into the hands of a doctor like that. So, I decided that if I wanted the surgery that I would have to go to another city. Dr. Edward Waits is now my surgeon, he had been wonderful and he knows that no matter what he charges the most that he will get is what the insurance company states is Customary and Reasonable! So please make sure you do your homework! When making the first appointment ask wha their policy is regarding fees! — Teresa M. (posted on May 31, 2000)
May 31, 2000
I am originally from Phenix City, Al, and recently a friend of mine has
been interested in WLS. I had my surgery in April and she has been so
impressed with the results that she has started the process and research
needed to make her finally decision. I am so glad that you posted the
infor on the doctor in Columbus so that she will stay away from him. Where
is Dr. Waits located? Best of luck on your WLS.
— ann A.
May 31, 2000
I agree w/ you about some surgeons trying to take advantage of
the morbidly obese.I had an experience w/ a physician that is well
known in the Cleveland area for doing gastric bypass surgery. It left
me devastated, cause I really wanted the surgery (and needed it). I went
to
the hour long presentation that they have on the surgery at St Vincent's
Charity
Hospital in Cleveland quite excited about the prospects of finally being
able to get
the surgery! After the presentation, I was told that I had to see Dr
Sonopal (sp?).
Basically, he asked me what insurance I had and I told him Medicare. His
next question
was, "do you have sleep apnea, diabetes or hypertension?" I said
no but I had other things
that were wrong w/ me as a result of my obesity. My BMI was about 60. I
think. He then stated
that IT DOES NOT MATTER what else I have wrong as a result of the morbid
obesity, that Medicare
WILL NOT PAY unless I had one of the three comorbidities that he mentioned.
PERIOD! He then acted like
he was "dismissing" me and I got up and left his office in tears.
In the hall I ran into someone from his
office staff and asked her about this. She looked sort of perplexed when I
told him what he'd said. She
said that there are many insurances that pay for the surgery. I said,
"well I guess that Medicare won't!"
then I left and cried all the way home cause I was sooo disappointed. It
was months after that when I finally
said to myself, (after going home and eating and eating thinking there was
no way out for me) I said, I am going
to try another doctor and see what they say. I contacted University
Hospitals Of Cleveland (Dr Thomas Stellato).
I told them that I have Medicare Insurance. They gave me an appt. I saw the
surgeon. To make a long story short,
they told me that there IS A CHANCE that Medicare will pay. They also said
that if I was turned down the first time,
that they would appeal it for me! They also offered me a monthly pmt plan
if nothing else worked. I was let know that
I was dealing w/ the government where Medicare is concerned and that it was
up to them if they'd pay. I was NOT TOLD THE
THINGS that Dr Sonopal (sp?) had told me at SVCH. (3 comorbidities only). I
was ECSTATIC. I was FINALLY given some hope that
just maybe I could/would have a shot for a healthy future w/ weight loss
surgery!! I am waiting for my surgery now. If it were not
for these wonderful, caring people at University Hospitals..I probably
would be sitting here morbidly obese for the rest of my entire
life w/ my health continuing to decline each day. I found out later that
Medicare does not pay the entire requested amt that is asked for
the surgery when they do pay. So, MY INTERPRETATION of this story is that
the OTHER HOSPITAL'S DOCTOR probably knew that and didn't want to
bother w/ me as a patient as they have just about all of the gastric bypass
surgeries in the greater Cleveland area (and others) done at their
hospital. The 2 doctors at SVCH are very well known and are experts in
their field from what I have been told and most people do not know that
there is another hospital in the area that does gastric bypass surgery. So,
I take it that this doctor decided that he did not need to bother w/
a Medicare patient. That even if they did pay him, that he would not
receive the amts that he'd get from other patient's insurance coverage
that
paid much more than Medicare did. Just think..what if I'd gone home and
never tried to find another doctor, or find out if what he'd said to me was
actually true or not?? I KNOW WHAT WOULD HAVE HAPPENED..I'd eventually
would have DIED FROM MORBID OBESITY. It is very, very sad that there are
doctor's
out there that think of $$$ first and foremost. What would happen to all of
us if every doctor doing the surgery felt like this??!
As you can probably hear, I am still very upset over what happened...yet, I
am MOST GRATEFUL that I found a surgeon that would accept me as a
patient for this surgery.{{thank you, God}}.
— kathy S.
June 1, 2000
Things happen for a reason... I am sorry that you had a poor experience
with your first doctor, however.... Dr. Waits is also my doctor and I think
he is the GREATEST!!!! I had surgery on 04/12/00 and am 7 weeks post op.
I have lost 46 lbs to date and was very happy with my experience with Dr.
Waits and his office staff. Just as an FYI, Dr. Waits has a support group
that meets on the second Thursday of every month! I hope to see you there!
Kim
— kimberly1224
June 1, 2000
YOU GO GIRL!!!!!!I will also be using Dr.Waits my surgery is scheduled for
6-21-00.I think his whole staff is simply the best
— shirley A.
January 17, 2001
I am in the process of searching for a surgeon in the state of Washington.
I noticed that the only one listed in my local phone book was a Dr. Fox in
Tacoma. Regardless of the fact that his name is listed on
Obesityhelp.com's site for surgeons in this state, something didn't seem to
be right to me; call it a premonition. Anyhow, after doing research on the
Internet, I came across some very important information: The state Medical
Commission put Tacoma physician Dr. S. Ross Fox (MD5293) on probation for
two years. To practice, Fox must agree to bi-yearly practice reviews,
carefully document all contacts with patients and orders for transfers, pay
a $2,000 fine, and comply with other conditions of the order. Fox was
charged with unprofessional conduct for performing surgery procedures which
left a patient in critical condition. In fact, according to the Washington
State Medical Quality Assurance Commission, it denied his request to
terminate terms and conditions of an August 7, 1998 order on December 15,
1999
(http://www.doh.wa.gov/medical/newsletter.html). I'm sure he was monitored
carefully and that if he's back in practice, the Medical Board has given
him the okay. However, as far as I'm concerned, I'm definitely going to
look elsewhere! We are putting our lives into the hands of these surgeons,
so it definitely pays to do some thorough research.
— [Anonymous]
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