REALLY MAD about Fibro & Fatigue Ctr- ***Dr Involved***

Discussion in 'Fibromyalgia Main Forum' started by bunnyfluff, Mar 20, 2005.

  1. bunnyfluff

    bunnyfluff Member

    I know they have helped a lot of you- but let me tell you what happened to me. The main Dr at the FFC here is a preferred provider with my insurance. He also has an office not too far from my home.

    I called his office to get an appt to see him & have a few tests run, which my insurance would pay for, and I was told that he WOULD NOT see a fibro patient thru his office, only thru FFC, which is a francise, and will not take the insurance up front. According to his agreement with my insurance company, he cannot refuse to see me, if he is accepting other patients into his office.

    They also tried to tell me that my insurance WOULD NOT pay for a claim if the diagnosis was FMS, and I said, well, they've been paying for 3 yrs without a problem.

    So, I was put on hold, and the receptionist came back and said- well, you need to go to FFC. He won't see you here. I'm sure he won't because they can get people to pay $325 for initial consultation, and the insurance would only pay them, say $70.

    Needless to say, I filed a complaint against him with my insurance company, and I am having him investigated. There is no reason he could not take blood and run the tests thru his office. I am not severely ill and bedridden. I work every day, and am fairly well managed. I just wanted a few more specific tests run.

    I know some of you are being helped, but this guy rubbed me the wrong way. He is not there to help people, he is in it only for the money. Just my opinion.
    [This Message was Edited on 01/06/2006]
  2. desertfog

    desertfog New Member

    I'm sure sorry he would not help you through his regular office. I wonder if he has some kind of agreement with the clinic to not treat people outside of it.

    It just seems like so few of us get breaks with dr's. I hope you can get this resolved.
  3. ertekate

    ertekate New Member

    Let's hope that he has a better reason than simply being a jackass. You sound frustrated to pieces! KatieB
  4. jarjar

    jarjar New Member

    I use to go see him before he opened up the new clinic. He was also on my ppo and charged about 300.00 an hour if you had cfs or fms but regular ppo charges were applied if you had any other disease. He would not file insurance even though he was on my plan because he tries to make more money off of cfs and fm. His wife and son have the disease and he takes them to Cheney and keeps up with all the new treatments so he has been able to get away with it.
    My first visit he billed them in some fashion where they covered most of my first expensive visit.
    I agree he is trying to cash in on the disease. But he does keep up with all the latest research and treatments.
  5. skyeone

    skyeone New Member

    First off I'd like to say that i feel for you in the way you were treated. I think you did the right thing by making a complaint. Quite frankly, even though i'm from Canada i believe the majority of Dr.s out there are only in it for the money. the doc's around here have no clue as to how to treat me, nor are there any real FM/CFS specialists. So far the ones I've found who claim to be, know less than I do about these deseases. At least that's the way it feels when they tell me to go home and take some T-3's and go from there, without any tests done.

    Good luck in finding someone who will actually bea ble to help and willing to.

    HUGS

    Skye
  6. garlinbarb

    garlinbarb New Member

    It wasn't that long ago that docs would see you regardless of your ablity to pay...then all the ins co,hmos etc got into it and it's been a money grubbing mess ever sense!

    I'm glad you filed a complaint on him. I don't think Cheney takes ins either.

    I wouldn't go see him if my tail was on fire! Find someone else.
  7. jake123

    jake123 New Member

    Who is the doctor? I sure want to give him a pass if I'm ever in need.
  8. rigby

    rigby New Member

    He needs to be reported to the insurance board for you state. Rigby
  9. zenouchy

    zenouchy Member

    Dear Bunny,

    To be honest (and this is my opinion as well), I always felt a bit leary of the F & F Centers because they charged so much and were franchised.

    Any doc's office that's become a franchise to me cannot offer consistency from one place to another.

    Additionally, the prices they charged are just plain pricey. I do not see what these docs are doing for the patient that any other doctor can do for less money. Cheaper is not always better, but I do not see any value-add in what these docs are doing for the ridiculously high prices they charge.

    These two things raise red flags for me and tell me that these docs are less than sincere and out to make money off of us.

    I agree with your decision to file a complaint and would follow up with the filing and make sure you aren't blown off. Good for you! I love people who take action!!

    All the best,

    Erika
  10. bunnyfluff

    bunnyfluff Member

    I don't know what is wrong with people today. These Dr's take an oath, but it seems to mean little.

    I think that there are lots of people who try to capitalize on these DD- the people who have them feel so bad, and have lost so much, they are desperate to try anything.

    Cheers to all they have helped, but you won't see me there.
  11. zenouchy

    zenouchy Member

    The doc who started the F&F Centers says he had Chronic Fatigue Syndrome! That's what it says (or said- I haven't looked in a few months) on the F&F website.

    So here he is, trying to relate to us as he's also trying to in my opinion take advantage of us at the same time. This to me is very sleazy!!

    I'm glad for others who have gotten results from the F&F Centers, but again, I still find the place VERY pricey.

    I'm still glad you're reporting them for that reason- there's no reason to price gouge and violate an insurance agreement. Way to go!!

    Erika :)
  12. Pinkgirl

    Pinkgirl New Member

    I am on medical assistance because my husband's insurance through work wouldn't cover me for more than 3 months (we'd still be paying for me of course!) and it is getting so hard to find treatment!!!

    I had to drive 3 hours (one way) to see a dentist that would give me a plate instead of just yanking my teeth out and leaving them! Now, I cannot go back to that dentist because they had such a hard time EXPLAINING THE BILLS TO THE INSURANCE!!! How is that my fault? They couldn't rationalize their bills to satisfy the insurance! Maybe they were charging an insane amount??

    Okay, sorry for ranting on your thread... :)

    I hope you find a better dr soon!
    Hugs,
    Love
  13. bunnyfluff

    bunnyfluff Member

    I talked to our FP Dr, who i think has only seen me for a sore throat, and he agreed to take blood and have any tests run that I wanted. He is a DO, and very into finding a cause, not just issuing a prescription. Cheers to him, for caring!

    I also find it strange that at FFC they have the lab there, and most all of the findings are the same. BTW- don't they also sell expensive suppliments there as well?
  14. ValB626

    ValB626 New Member

    We had a first appt at the Pittsburgh FFC on Wed. Our impressions were favorable. Like most everyone who suffers from these DDs, we've been through the wringer with our own PCP and the many specialists and alternative providers we've seen. My daughter has been disabled for about 6 years now, so you can imagine everything and everyone we've tried to no avail.

    There were several things we appreciated at the FFC that made the visit less painful than a usual first visit to a new healthcare provider. Believe it or not, one of them was that the offices were cheery, professional, and nicely appointed. More importantly, the dr. and staff clearly take this DD seriously. And, the amount of time the dr. and staff spent with us was unbelievable. There was no hurrying to get us in and out, and the dr. took all the time necessary to explain their treatment framework to my 19 yo daughter, which ended up being several hours.

    Yes, it's expensive. But our own PCP also charges a high hourly rate for the "consultations" we have with him every 3 months for medication/symptom reviews, too. I don't object to paying for a dr's time and individual attention. And the FFC dr. was up-to-date on every possible causal factor and treatment option I've read about anywhere. This is very different from our previous experiences with other providers who have typically had one treatment regime they were "pushing" or our PCP who just doesn't have the time to read everything published, let alone learn to administer the treatments (eg. the use of Xyrem for sleep).

    They don't do blood draws in the office at this FFC. We had to go to a Quest center a few blocks away for the blood work. I've been told that the FFCs have a blanket contract with Quest for these services, so it isn't obvious to me that the FFCs make alot of money off the testing. The tests he ordered were more extensive than any other testing my daughter has undergone to-date. Further, because Quest is an accepted provider for Blue Cross, our insurance will cover the testing.

    I personally think setting up the FFCs is a brilliant business idea and hope that they flourish. I don't mind it if they make good money out of it because they offer unique services. Few of us have geographical access to dr's who specialize in FM/CFIDS and understand all of the in's and out's of these DDs or track the most recent research and treatment options. There is no question in my mind that we represent an under-served "market niche."

    At the same time, ironically, we don't have much hope that any treatments prescribed will help much. But, to me, it's worth the extra $$ for the professionalism, responsiveness, time, and flexibility to explore all of the options that are currently available. More power to 'em, IMHO.
  15. ckahele

    ckahele New Member

    after spending countless dollars and hours with docs who have no idea what their doing i decided to go to a place where that fm/cfids is their entire focus.
    i believe the costs are as such because the insurance INDUSTRY hasn't kept up with or doesn't care to keep up with the treatments and protocal necessary for us.
    my first appt is on 3/29..i'm counting the days.
    i'm a divorced mom who recieves no child support so it really is a struggle to pay for it but i feel i must.
  16. dobrydy

    dobrydy New Member

    I am pretty sure it is Larry Sharp you are talking about. His phone consult is $150 per 30 min, and you pay upfront with credit card,and then if you run over this limit ,the charges will be added to this amount. He seems to know what he is tallking about though, so it is your call.
  17. Jeanne-in-Canada

    Jeanne-in-Canada New Member

    It may not just be a money thing w/ him. And he obviously cares about people w/ FM/CFS is his wife and child have it. Let me tell you a little story that may explain what is going on behind the scenes that his modus operandi is the way it is.

    I live in Ontario, but when I attempted my move to BC, I found out the hard way that the healthcare system is set up very different in other provinces. What had always been covered through any doctor was suddenly not covered in BC. They totally discriminated against the treatment of certain illnesses and a doctor could treat you w/ conventional (good ole boy club) medicine and that would be covered, but if he offered the option of treating alternatively, then suddenly it was a different set of provincial gov't regulations and then you had to pay out of pocket.

    I suspect that's what he may be dealing with. this may be a legal issue. You should try to find out before you push too hard w/ your complaint.


    Jeanne
  18. Countrymom

    Countrymom New Member

    I too, agree with Val and would like to add that I have been nothing but impressed with the quality of care I have received at the FFC. They are very up to date with their treatments and have weekly conferences with all the FFC docs around the country and adjust their treatments as needed based on what results everyone is getting.

    They charge $325 for your initial visit, which is the same as my rheumatologist charged by the way. Of course I spent about 10 minutes with him(and he told me to exercise, lose weight, and eat better) and over an hour with my doc at the FFC. And they get everything ready for you to submit your claims to the insurance company so that you can be reimbursed.

    You stated that
    "I am not severely ill and bedridden. I work every day, and am fairly well managed. I just wanted a few more specific tests run."

    If you have FMS/CFS then you are severely ill,period. It is like being pregnant, you either are or aren't You have been lucky thus far that you are as active as you are and haven't felt as bad as some of us. although it does seem to have affected your attitude.

    You are right to want further testing. All of us need it. The FFC is on the right track. They have over than 90% success rate. He probably knows he cannot provide the quality of care you deserve at this office because of the guidelines YOUR insurance company places on him.

    I am sorry that you had a bad experience but at the same time you are being shown how you can get the care you need. It is like salvation, it is there for you. It is your option to take it or refuse.

    I am so glad that I found the FFC and have had extensive testing and found out exactly what is wrong with me, which by the way, I have spoken to numerous patients and NONE of them have my exact testing results and none of us are on the exact treatment plan.

    If I were you, I would run to this office and be happy to find out what is causing this awful disease.

    And another thing, I don't have a problem with the FFC making money off of me. My husband sells to major corporations around the world and makes money, so why should a doctor save our lives for free? I handmake items and then sell them for a great profit as well. Why is it that people think doctors should not make any money for their work? Believe me, I would rather not pay anything out of pocket either, it is very expensive. But at least I am getting to the root of the problem so that I can start healing, if I had to pay someone to help me, well then, I can live with that.



  19. jake123

    jake123 New Member

    My ob/gyn told me that they were chucking my ins. company because they were imposing riduculous conditions on the doctors in that clinic. Like 3=5 minutes per patient. He always talks to me about health issues that I have telling me what to ask for from rheumy to neuro.
    So that might be the reason he is insisting on the FM going thru the FFC clinic. His time is expensive but at least you get it!
  20. KingNeptune11

    KingNeptune11 New Member

    I feel your pain, but there are some "political circumstances" surrounding our illnesses........Sure, the CDC will be happy to acknowledge that CFS and Fibromyalgia are illnesses on their website, but try and get disability and see what happens......Its just ridiculous........The problem is that the doctors are NOT going to get reimbursed for an FM/CFS diagnosis in their own office, so that is probably why he wants to treat you at the FFC.......Not to mention that he probably has an agreement in his contract with the FFC, if he maintains his own clinic........I understand your anger, we are all angry with our condition and the way we get treated, but its not the FFC's "doing".......Its the politics behind our illness, plain and simple.......The FFC has to do things outside the "scope" of what is considered medically accepted, so that leaves insurance coverage on a limited basis.......

    I have had this CFS illness for over 10 years and I have researched all the protocols out there, I can tell you that the FFC is the most comprehensive and effective, in my opinion.......I have been to Dr. Cheney, Dr Lapp, and Dr Guyer and they are all good doctors, but I dont think they are doing as much as the FFC's.......Now, I understand Dr Cheney is now doing alot of "cardiac work" with his new theories, but I dont see that as an effective answer for all of us........I do respect all of the above mentioned doctors, but I dont think they have all the answers.......But Dr Cheney and Dr Lapp were the first ones to really look into this illness........

    That being said, the FFC protocols are very solid, based on the research that I have read, as others have discussed here as well.......It is so important to do a "comprehensive" blood work up, to determine what each individual is dealing with, as we are all different......I do believe that most of us are dealing with a combination of mycoplasms, viruses, thyroid problems, adrenals, heavy metals, and many other infections........As I have mentioned before, there is a reason that we are dealing with "political issues" surrounding our illnesses.......I suggest you read Osler's Web by Hilary Johnson and research Garth Nicholson and his findings........As most people on here know, I think that we are dealing with "bio-weapons" from our government/military, which would explain the politics behind our illness......and Hilary Johnson says the same thing in her book, that the government is "covering up" and dragging their feet on research.......Its just too obvious if you do your research........They dont want to find a cure, much less, admit that its a real illness........

    The bottom line is this, there are no guarantees that any of us can recover from this, much like the polio virus.......But, the FFC is giving us a fighting chance, in my opinion......For those of us who are the "sickest", I really believe we have to use anti-biotics aggressively, to kill the mycoplasms and infections, or at least reduce them, so our immune system can take over.......Its also of upmost importance to use supplements and eat a strict diet, in my opinion........Try not to let this get you down Bunny, keep your eye on the target of getting well and dont let the "man" get you down.......JOhn