Surgeon is moving and I'm out $$. What should I do?

Parent Cafe
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I am in desperate need of a septoplasty. My nose has had one too many run ins with giant cranky toddler heads I think. A year and a half ago, I visited 3 surgeons and picked a hot-shot guy with a lot of experience, awards and stellar ratings–who also has a great bedside manner.

Last year, I only had a high deductible insurance plan so I paid for all the deductibles and copays for preliminary appointments out of pocket. This included another specialist visit and a CT scan (to rule out possible issues related to what is the most common deviated septum symptom–i.e. I did NOT need the neurosurgeon visit OR the CT but that’s another issue). As you can imagine, each visit, test, etc took weeks to get an appointment so this has been quite a long process. In December, I got as far as having my preop appointment at the hospital though.

After the results from the tests and specialist were back, I was officially cleared for surgery. In February, I started calling the office to try and schedule my surgery. I couldn’t get anyone to call me back which I thought was weird. So, I also messaged them through the portal.

Finally, at the end of February, I get an email that the surgeon is moving, leaving the practice at the end of April and is no longer scheduling any surgeries. The practice does not have any other ENT surgeons-which is sort of good because I have a 2nd and 3rd backup choices who are associated with a different hospital.

Ughhh…I spent $1600 getting ready for this so far. This year, I have an insurance plan with a $250 deductible, so going forward, additional OOP expenses will be minimal.

BUT I am still ANNOYED. I wasted all that money and I want some kind of a refund. Do I have any recourse? When I do get the surgery done, it will now be a different hospital–with another preop visit.

I called the original clinic today to ask them to have my dr send a referral so I can get an appointment set up with the new surgeon. The scheduler kindly told me she would ask the Dr. to do it if he has time. :open_mouth: :astonished_face: Huh?

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Find another ENT practice - have your records sent, and they can evaluate.

When you have a high deductible plan, you are paying out of pocket but at the insurance negotiated pricing.

In the end, you can still have surgery. You might have to do another office visit - but your surgery is going to take you over max out of pocket - so your overall expense is going to be the same anyway.

In the end, you have an issue you need resolved. So get it resolved. You might seek other ENT references from folks you know or facebook, etc.

These surgeries are probably routine for most - and i’m sure you’ll be fine.

Good luck.

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Can you find out where he is going? Maybe it is not far away and you can transfer your records.

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I found another ENT already. Off and running there.

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Yes, that was my first thought…although it took weeks to convince the clinic manager to tell me that. They all just kept saying “We dont know where he’s going.” Yeah, right.

Finally got it out of them…unfortunately he’s going to Alaska…which I did confirm.

There are many relevant details here related to how some of the decisions and information I got from office staff there ended up costing me a lot more money.

For instance, I asked if I could wait to do my pre-op at the hospital until after the neurologist report and the CT scan and my last appointment with the surgeon were done. The office staff said “no we need to get you on the schedule and get that done now.” That could easily have waited.

My hospital pre-op was on December 29. I was told someone would call to schedule the surgery as soon as the neurologist’s report was back. They got that report on Jan 13. Crickets from them. I dropped the ball and didn’t call them myself until February.

I found out through conversations with the clinic manager and the medical assistant that if somebody had called me back when they got the report OR in February when I was leaving messages that I wanted to schedule my surgery, I definitely would have gotten on the schedule because they were only scheduling 4 to 5 weeks out at that point.

The clinic manager did tell me she agreed I was due some kind of a refund but that her hands are tied and she can’t do anything about it.

Uggghhhh…

I know I’m dreaming. I’m not the only one from this practice in this boat. I’m sure others are worse off than me. Im just surprised a surgeon can leave so many patients hanging.

Oh wait. No I’m not.

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Just a thought - rather than a refund, could you ask that they pay any duplicative costs?

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Thats a good idea.

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Some inside baseball here.

It may be an issue with the practice owners. The surgeon may only be an employee, most physicians are employees now who may have very little control over the way his practice operates.

It’s frustrating for the physician. He also has a non compete clause and so can not inform his patients about his move.

My husband had a surgery, his surgeon was great. The practice owned by the hospital system was the worst I have seen. They were downright hostile, I felt they actively worked against the patients and the physicians.

Soon after surgery all the surgeons in that practice left to another location. Physicians don’t always want to uproot their families, sell their homes and move to a new location. But the administration can be really hard to work with.

There are lots of reasons people move to a new job. Sometimes it’s for more money, move to a location you want to be in. Sometimes it’s for a better work environment that you have more control over. Mostly though, moving is something that is done without warning patients because of those pesky non competes.

As far as getting a refund, that I don’t know about.

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Many groups are owned by VC groups. This is more typical unfortunately. With the doctor leaving it could be a contractual thing to not disclose.

Find a practice to take your previous tests. They really shouldn’t need to be repeated. You can also talk to your insurance company for help to see if there is anything they can do. Some practices are horrible at well, practicing. Some reviews are good but most hospital doctor group reviews are controlled by them. You can also talk to the office manager for the office and explain your situation. If they react kindly and on time than you have a good office. But no patient should be left hanging. Crap does happen but getting back to you in a timely fashion is mandatory. If I have any issues like this not getting back I just move on. I go to doctors that have great staffs and are quick to respond. To me that is a small sign of an efficient office. Good luck.

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I am flabbergasted that all of that was only 1600 out of pocket with a high deductible plan. This is unfortunately the way that insurance works when you have a deductible. It is great that you have a backup scheduled with someone you like. They should be able to use what was done already to plan the surgery and if you have a low deductible you will pay almost nothing!

Out of curiosity who do you think should give you a refund? The surgeon? The hospital where you did the preop consultation? They all did their jobs and you got your work-up, should they not be paid for it?

Good luck with your surgery!

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According to the clinic manager, the schedulers who were supposed to call me in mid January didn’t do their jobs. They also didn’t do it throughout February when I was calling and leaving messages. Same with my “care team” who I also started messaging on the portal in mid February. She was also shocked they had me do my pre op appointment at the hospital before they knew I was even cleared for surgery. The nurse I had that appointment with thought that was very weird too.

The clinic manager said this has gone much differently than any other time they have had a surgeon leave…that always before there was some kind of arragement made with replacement drs/surgeons so they could ensure continuing care. Some patients did have their surgeries scheduled for May and beyond and those were just cancelled with no help (I asked who was going to step in and do those scheduled surgeries and she said the patients individually have to figure that out.) I am surprised at her level of transparency…I can tell she is super frustrated with her role in managing this right now.

She did say she was authorized to recommend two other surgeons. Neither of them take my insurance (Regence…which is very widely accepted around here).

You are right about the doctor-other than not doing the surgery he told me he was going to do, he did do his job. It’s the “understaffed” clinic that dropped the ball.

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“Best healthcare system in the world.” My ass.

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Some suggestions & points to consider:

  1. you’re not going to get a refund of anything spent at your original surgeon’s office.
  2. At NEW surgeon’s office, fill out a form requesting all of the medical records from orig. surgeon’s office to be sent to new surgeon’s office.
  3. Then go to orig surgeon’s office and do the same. Fill out same/similar paperwork requesting all records to be sent to new surgeon’s office. When completing the form, go in person and ask or CALL and ask what is their standard turn around time for them to complete such a request.
  4. Whatever the turn-around/completion time is, add a reminder to yourself to check with new surgeon’s office on or right after that completion date. Purpose is to confirm that new surgeon’s office has, in fact, received the new records.
  5. Expect old surgeon’s office to not meet their turn-around timeframe that they told you. When they fail to meet that, call and complain. Better yet, go in person and politely inquire. Fill out the form again. Ask to speak to the office manager and politely express a concern that their delays in completing your request is preventing you from getting access to care.
  6. Then do #2 again.
  7. Then do #4 again.
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Ha. In the back of my mind, I know this to be true. Even if I had a better argument than I do, I cant see cash flowing from system to patient. Im sure there is no mechanism for that.

I can’t help though to consider a similar situation if I was getting my home repaired. If I paid a contractor to to meet with me twice and he promised to do the work and then no showed, I’d be frustrated and feel ripped off and like a lot of time had been wasted.

This condition feels like a somewhat urgent situation to me because I am not getting any air at all on one side of my nose and that combined with the terrible sleep at night is wearing on me. The “system” though doesn’t think it’s urgent (and I realize that technically it’s not) so I am wanting to hold the system accountable for the months long setback.

Good advice. Unfortunate this is what we have to do.

First surgeon’s office was 90 minutes away. New surgeon is almost two hours. Hopefully phone calls will work.

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What did you pay for upfront that did not and will not happen? That is what I would expect to be repaid. You paid in advance with the expectation of services to be rendered. If they cannot provide the services because there is no longer a doctor on staff who can provide them, what could possibly be the rationale for keeping the money? If everything you paid for happened - even if it was all for nothing because the doctor left & it has to be done again by another doctor - I would guess you’re out the money, unfortunately.

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I have known from the beginning that this was the case. My frustration is not with the surgeon…he is a human with a family, career goals and an opportunity that better aligns with his career goals presented itself. Even where the short notice is concerned, I recognize that new employer may have leveraged some power there.

My frustration is with the system where it takes forever to get even the simplest thing done, or appointment scheduled, where unnecessary tests are ordered to CYA, where the right hand doesn’t know what the left hand is doing, wherenthere apparently was no backuo plan for continuing care if ine if their providers left, and where patients are 100% at the mercy of the person on the other end of the phone.

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I’ve never heard of this specific situation.

But I have had success negotiating an “out of my pocket” bill with both physicians and my current dentist. I don’t have dental insurance and even though the practice keeps trying to get me to sign up for something they claim will save me money, I’m not interested. But I pay cash when I go and the billing person at the desk told me “you’re getting a cash discount for not making us do paperwork”.

The saving on my colonoscopies and the follow up have been very big. I pay the gastro with a check when we schedule the procedure.

It started years ago when I was in a high deductible plan, needed a procedure in December, was nowhere near my number so I said jokingly “do you give a cash discount?” and the doctor looked at me and smiled and said ‘heck yes”.

So maybe ask the new surgeon what the difference in price is between your part of the bill post insurance and just paying out of pocket? It costs them money to run it through your plan…. and takes forever for them to get paid….

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I went through this very same thing when I was pregnant with D26. Started out my OB care with 1 provider, then I switched to a different practice when I was 4 months pregnant.

Filled out all of the ‘transfer my medical records’ forms at BOTH the 1st OB’s office and the new provider’s office. I filled it out 3 separate times over 3 successive months because 1st OB’s office never actually sent anything.

It finally got to when I was almost 8 months pregnant and the new provider’s office said that if they didn’t receive my records soon from 1st OB’s office, then they’d have to drop me. Right after that appointment, I drove straight to 1st OB’s office…

Got the same run around I’d had every month prior.

But this time, I was SUPER pregnant. And annoyed. But I explained politely (and a little louder than I normally speak) what new provider’s office was telling me. I even threw in stuff like, “I’m happy to fill out this form again, but I have now come here multiple times and filled out the same form 3 times before today. And new provider hasn’t yet received my records. So I’m happy to wait here in the waiting room while you make photocopies of my medical records. Then I will drive them over to new provider’s office myself. I’ve taken the rest of the day off of work for this because this is really urgent. I do have a right to a copy of my medical records. If you don’t mind, is there please an office manager I could speak with who might be able to help me? Because at this point, based on your office’s track record so far, I don’t have any confidence that my records will, in fact, be sent.”

It got REALLY quiet in the waiting room. ALL of the other patients were pretending to be engrossed in their phones, magazines, etc. But EVERYBODY was waiting to hear what happened next. :rofl:

Front desk person stepped away for a sec to go talk to office manager. Office manager then came to front desk, assured me that it would be faxed over today. I thanked them profusely for their help. AND told them that I’d be calling new provider’s office the next day to confirm they’d received my medical records.

so don’t trust them when they say the records will be sent. Verify it. And if there’s a delay, stay on them about it until it gets done.

Based on how medical insurance claims work, there is NO way you will get a refund from the surgeon’s office. Those exams, tests, etc. were already completed.

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The preop appointment at the hospital (where I got all my supplies, was shown where to go and what to do day before and of the surgery) This hospital is now out of the picture. Even the two doctors the clinic recommended do not work out of that hospital.

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I have a very low deductible plan this year and have already met that, thankfulky.

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