Texas Lap Band Surgeons Talk With You

Last week, we wrote about an arbitrary decision by Blue Cross Blue Shield to remove the designation as a Blue Bariatric Center of Distinction from Wadley hospital here in Texarkana. This was despite the program having that designation for several years, and nothing changing in our program and having no patient deaths or changes in outcomes compared with previously.

Together with the multiple emails and phone calls I have made, and the pressure from emails and phone calls from concerned patients, Blue Cross Blue Shield has extended the deadline for Wadley’s designation as a Bariatric Center of Distinction for 2 more weeks until March 12. They have indicated via email that they will review the situation, but have not allowed us to participate in the debate or review process.

We remain concerned that despite this 2-week reprieve, they might remove the Center of Distinction designation on March 12, and thereby deny access to care for many of our patients.

I urge you to email and call the representatives below. They are the ones that I have found are most involved in the decision process.

Dr. Carole Flamm
Executive Medical Director Office of Clinical Affairs Blue Cross and Blue Shield Association
312-297-5905
Carole.FLAMM@bcbsa.com

Dr. Allan Chernov
Blue Cross Blue Shield of Texas Medical Director
allan.chernov@bcbstx.com
972-766-1149

Are you nervous about talking to an insurance company employee? You shouldn’t be, but if you are, send them an email. Or call them after hours to leave a message on their voice mail. If those insurance company employees come to the office in the morning and get dozens of emails or voice mails from people upset with their arbitrary decision to deny access to care, it will get their attention. The fact that they gave us a 2-week extension means that we have their attention.

There is a LapBand patient and advocate on Facebook named Cher Lewis who lives in Dallas who is sympathetic to our cause. She invited me to be a guest on her Internet Radio talk show to discuss this issue because she sees this as a dangerous trend towards the denial of access to care by an insurance company. I’m glad to see that someone outside of Texarkana has taken a stand on this issue, and I urge you to do the same.

This is not only a health issue, it is a consumer protection issue. Each year insurance companies raise their premiums at a painful rate. I know this personally, because in our office we doctors pay for Blue Cross of Texas policies for our families and our employees. Each year we pay higher and higher premiums. Yet as doctors we generally get the same or less each year for the same procedures or office visits. So where does this money go? It goes right into the pockets of insurance companies.

Don’t let them get away with this. Be creative. Use Facebook, MySpace, and Twitter and enlist others in your cause. Get people in your church and workplace to call.

Even if this doesn’t affect you directly now, it might in the future. If today an insurance company doesn’t allow you to get bariatric surgery, what will stop them from denying other care for any other medical problem in the future? Let’s make a stand together, because together we can show the insurance companies they work for us, not the other way around.

Regards,
Dr. Ron Hekier

PS Later today I will send out a lengthy email explaining the history of the Center of Excellence centers and what it means for the future of healthcare in this country.