Re: My letter to: JEAN from Pennsylvania about Dr. Redan....

From: Mary Wade (acbcsrt@kansas.net)
Sun Feb 25 06:35:34 2001


Jean--Something in your letter struck me as "Ut oh....think we have to figure this out." It was your comment that "I am just hoping since there aren't procedure codes (as I have heard >from some people) for the operation that my insurance doesn't refuse to
>pay anything." that has me concerned and confused. This was not my
experience with Dr. Reich and Redan. There WERE procedure codes for the procedures that they did. Could you clarify on this point? Thanks. Your friend, Mary

At 12:52 AM 2/25/01 -0600, you wrote: >At Sat, 24 Feb 2001, Helen Dynda wrote:
>>
>>Jean ( creative@enter.net ) from Pennsylvania said: "I asked my MD to write
>>a referral paper for Dr. Redan cause even though I don't need referrals I
>>read on here that it may help prevent insurance problems. He refused, since
>>he never heard of them.
>>
>>~ ~ ~ ~
>>
>>Dear Jean, I am so sorry to hear that your doctor refused to give you a
>>referral to Dr. Redan.
>>
>>You might ask your doctor if he has ever heard of Dr. Harry Reich. Dr.
>>Reich is "the most talented laparoscopic surgeon in the world!!" Dr. Reich
>>performs surgery at both Community Memorial Hospital ( CMC ) in Scranton, PA
>>and at St. Vincents' Hospital in New York City. Since you are from
>>Pennsylvania, surely your doctor has heard of Dr. Reich.
>>
>>In April 1999, Dr. Reich performed a successful adhesiolysis procedure for
>>Deb. I saw Deb's video -- her abdominal and pelvic organs were completely
>>covered with adhesions!!. It took Dr. Reich 10 hours to complete Deb's
>>surgery!!! Deb is pain free today!!
>>
>>For a long time Dr. Reich realized that postsurgical adhesions have been
>>causing so many people problems with chronic pain, infertility, bowel
>>obstructions, etc. Since he had been experiencing success with his
>>adhesiolysis procedures, Dr. Reich made a decision to specialize in
>>performing adhesiolysis procedures. Since Dr. Reich's specialty is Ob/Gyn,
>>he needed to find a General Surgeon to be his surgical partner. It was then
>>that Dr. Reich personally chose Dr. Jay Redan to be his surgical partner.
>>Dr. Redan is a very skilled and experienced laparoscopic surgeon too.
>>
>>On May 1, 2000 these two surgeons opened the very first Adhesions Unit in
>>the United States at CMC. Since then Dr. Reich has been working very
>>closely with Dr. Redan -- at both CMC and St. Vincents Hospital --
>>specializing in adhesiolysis procedures.
>>
>>When adhesion involvement is very severe, such as in Deb's case, it is
>>extremely important that the surgeon is very meticulous as well as extremely
>>cautious as he lyses adhesions...for the safety of the patient and to give
>>the patient the very best chance to become pain free. The surgeon must be
>>sure that there is NO blood or other debris ( such as talc from the
>>surgeon's gloves, lint from sponges, etc.) left in the abdominal cavity. He
>>must also be very careful so that he does not traumatize internal organs.
>>All of this takes time...a lot of time, if the lysis of adhesions is going
>>to be a success!!
>>
>>When a surgeon tries to complete an adhesiolysis procedure in a maximum of
>>1-2 hours, the surgeon's decision -- to complete the adhesiolysis procedure
>>within this time frame -- does NOT show consideration for the safety and
>>well-being of the patient. Chances are the surgeon is "rushing" the
>>adhesiolysis procedure simply because he knows that an adhesiolysis
>>procedure is the "most underpaid" surgical procedure that Medicare and other
>>insurance companies reimburse the surgeon for.!!!!!!!
>
>Helen,
>Thanks for your response to my post.
>I think I also mentioned Dr. Reich to my MD, but not sure.
>I will ask the general surgeon when I go, if I am lucky maybe he will
>know one of them.
>
>I know exactly what you mean about the rushing etc.
>I do believe what you say about Dr. Reich.
>I definitely prefer someone who cares and is gentle!!
>
>I am just hoping since there aren't procedure codes (as I have heard
>from some people) for the operation that my insurance doesn't refuse to
>pay anything. I definitely can't afford to pay the entire doctor bill
>AND the hospital. I would go out of network and don't know if they
>would definitely be required to pay?!? When I asked for codes Sue
>couldn't give me any so I could check with my insurance. The insurance
>said I need diagnosis codes and procedure codes to see if it qualifies
>and for how much.
>
>I do already have a problem going on right now with the insurance
>refusing to pay for my nursing home care of 6 weeks (big time money).
>The nursing home has appealed it about 6 times now in 7 months time.
>The insurance company was the one who said they would only pay for my 4
>weeks of intravenous "if I was in a nursing home", but not as an
>out-patient with a visiting nurse coming in to start & stop it twice a
>day so I had no choice. The nursing home "is a participating facility"
>so it is in-network.
>These HMO's are something else!!! I know they definitely are not in
>business to do anyone any favors and will do whatever it takes to get
>out of paying if possible.
>
>I also never got my money back ($900) from that doctor who double-billed
>(me & the insurance) even after I got a lawyer.
>He couldn't believe it either....my kind of luck!
>
>Hope you are still feeling good.
>JEAN
>
>--
>Jean (from PA)
>


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