Very Disappointed

Hi all, Yesterday I was flying high because I had made the best decision of my life and had an appt to see Dr. Crum on 6/3/04. Today, I get a letter from the office stating that on my first appt I have to pay them a $200 fee because they aren't getting enough reimbursement from the insurance companies. I think this is a rip off. Has anybody else experienced this? Should I look for another Dr? My opinion of this surgeon has now changed.

I think the fee is because Your insurance company won't pay their fee for the consultation. Everyones insurance is different, but my experience with Dr Crum has been wonderful and he is well worth it. Good Luck in what ever you decide. Darlene RYN 11/10/03 309/245/?

Hi Darlene, thanks for your response I'm still going to see Dr. Crum because I believe that he is good at what he does, however, I am going to consult with another surgeon too.

I haven't had this happen, but I wanted to show my support. I agree that it sounds like your insurance won't cover the consultation fee. I would call the insurance company and see if this is the case with all Drs or you have to use a network one to get it covered. It's possible that the insurance won't cover any of the consultation fees. If you are that unhappy about it, definately call around. You have nothing to lose. If you want to stick with this Dr., $200 is steep, but in the long run the happiness you'll get from the surgery will be worth every penny. Good luck, Maggie

Hi Gina I am a pt of dr crums and fortunately my insurance covered the whole consultation. i do know that my insurance was billed 325.00 for the initial consultation. but nothing about insurance companies surprises me anymore you hear such terrible stories. $200 sounds a bit steep but in my opinion dr crum is well worth it he is extrememly confident in himself and have a VERY low complication rate. i wouldnt blame it too much on dr crum i would doubt he even saw the paperwork from the insurance company it was probably someone in the billing dept who is just trying to do the right thing. good luck with whatever decision you make. and if you have any questions feel free to email me. take care cheryl K

I was really impressed with Dr. Crum until I got that letter. I am still keeping my appointment with him, however, I am now going to see Dr. Floch too. Thanks for your imput and I do believe that Dr. Crum is a great surgeon. Keep in touch

Each insurance company is different. For example, BC/BS in Michigan only reimburses 25% (yes twenty five precent) of WLS surgery costs. This is why some doctors only deal with specific insurance programs. Don't always blame the Dr. Peter

Gina, If this doesn't sound right to you, I suggest you call your insurance company and ask about their payment and their policy about the consultation fee.I don't like the sound of it and can understand your questioning it,but go to where you can find an answer.As someone in the medical field, I am glad to see you question a doctor or a "policy".It is your right and responsibility.We all have to be our own advocates because unfortunately as wonderful as our doctors,nurses and office staff may be,it is still a business with the bottom line the $$$$$.As far as my own insurance goes,everything has been or is being covered including all consults pre-op and each office visit pre and post until the first year point.I don't know if the difference is the doc or the company or both,but I had Dr.Bell and Anthem B/C B/S of Ct. Good luck and follow through. Carol

Gina - I am a patient of Dr. Crums (7 months Post). I have lost over 100 lbs so far. Looking back on everything over the past 7 months, if my insurance did not cover the surgery, I STILL would have had it done and paid for it myself and done only by him. He is a wonderful surgeon and his staff is fantastic. I know I am a bit biased, but I think he and his staff is worth EVERY penny. They are legit. I know that Maryanne and Jeanette in his office do about 30-40 hours worth of work getting approval from insurance agencies. This includes making sure all of your approvals have come in from the cardiologist, pulmonologist, psychologist, nutritionist and gastro-intestinal doctor that you go to see after the consult (if you decide you want to proceed). And they need to make sure your weight-loss history is in order and properly documented. There is so much paperwork that they do (peek into one of their offices)...I'm sure that the $200 is to cover the loss from the insurance company. Good luck with finding a doctor!!!!!!!