PMRI

Has any one been asked to pay 1200.00 by pmri upfront before anything can be scheduled?

Hello Rhonda, I was not asked to pay that up from. I had to pay for the life skills class. Then when I had my appt. with the nurse prac. and psych. doctor, I had to pay that 310.00 But nothing about the 1200.00 Did they say what for? Christie

Hi Christi, I spoke to Judy at pmri and she said it was for the 4 visits: Dietitian, nurse prac., psychologist and medical dr. I spoke to a couple of other people and they said they have never heard of the fee either. I don't know what to do. Thanks for your response. If you have any other info on this, I would greatly appreciate it. Rhonda

Hello Rhonda, One thing about PMRI is that somethings are not managed right. My class at Life Skills was discussing about this. I would tell her that everyone you talked to did not have this much to pay up front. Unless policies have changed but I was just in there Nov - End of Dec. for Life Skills, so I do not think that it has changed that much. Christie

Hi Rhonda This is news to me also. I had to pay for the Life Skills class. Everything else was covered by my insurance. (Aetna) I would double check this out with PMRI. Crossing my fingers for you that the person who gave you the information read the amount incorrectly. (Maybe a typo) Rose

Hi Rhonda, I had called 3 weeks ago to schedule my PMRI appts. and was told that after Jan.1st, I would have to pay the 1200.00 up front if i didnt pay for the Life skill before Dec.30th. So I paid for my LifeSkills class on Dec. 30th. Then I was informed on Jan. 4 that I would have to pay the 1200.00 up front. So I told Judy that I was not told that If i signed up for LifeSkills befor the deadline. Needless to say, after I told her that if my insurance wont pay for the PMRIs, then I was on my way up there for a full 275.00 for the class. She called me back and said that my insurance will cover it. So I only pay a co-pays and that is it. Try what I did.....

I'm 6 months post-op and didn't have the Life Skills class. It wasn't mandatory then. We had a 4-hour long nutrition class and then took a test we had to pass. But I can relate to your problems with PMRI. I cannot understand why they refuse to process insurance claims. I have Blue Cross/Blue Sheild PPO and PMRI is a participating provider because they are part of Christiana Hospital. According to my insurance company, I should only have to pay a $10 copay for each visit. But instead, I have to send in the reciept on my own, which wouldn't be bad, but most of the time PRMI doesn't mark off all the info needed for BC/BS to process it. So it's an ordeal that takes months to settle. And if BC/BS contacts PMRI they won't give them any help with the additional info. What I do now, is when I send in the claim I attach a note that if there are any questions or problems to call me, not PMRI! It took me 6 months of re-submittals and phone calls to get my first claim processed. But, getting that refund check -- finally -- was COOL! So even though PMRI usually tells people that they aren't covered by insurance, take the time to ask your provider. Send in a claim and see what happens! It's worth it if you can get money back! Good luck everyone< Kit

i only paid for the class for 6 weeeks .........275,00 and my insurance pd the rest..........

I had my first consult with Dr. Irgau yesterday. There's a handout from Christiana Care (I recognize the paper, font and colors as hospital generated) in the information packet from Dr. Irgau. It blew me away as I thought my insurance (Aetna) would cover the surgery and preop studies less my copays. The $1200 fee is for enrollment in the Weight Management Program at PMRI and in bold print says "you will be asked to pay in full when you register for the first pre-surgical evaluation and education class". It lists acceptable payment types and tells you to check with your health plan about reimbursement for services related to weight management. The fee covers Preop life skills classes, medical evaluation, psychological evaluation and nutrition counseling appointments, preop and post op. Also covers support group monthly meetings. Doesn't cover lab work/cardio/pulmonary evals, or tests (I'm assuming that's the EGD) I haven't called to schedule the appointments with PMRI yet as I'm still not 100% definite about having the surgery. I'll post when I get more information, I'd planned on calling Aetna and PMRI about coverage for the $1200. The way it's listed I'm not optimistic. Karen

I had my first consult with Dr. Irgau yesterday. There's a handout from Christiana Care (I recognize the paper, font and colors as hospital generated) in the information packet from Dr. Irgau. It blew me away as I thought my insurance (Aetna) would cover the surgery and preop studies less my copays. The $1200 fee is for enrollment in the Weight Management Program at PMRI and in bold print says "you will be asked to pay in full when you register for the first pre-surgical evaluation and education class". It lists acceptable payment types and tells you to check with your health plan about reimbursement for services related to weight management. The fee covers Preop life skills classes, medical evaluation, psychological evaluation and nutrition counseling appointments, preop and post op. Also covers support group monthly meetings. Doesn't cover lab work/cardio/pulmonary evals, or tests (I'm assuming that's the EGD) I haven't called to schedule the appointments with PMRI yet as I'm still not 100% definite about having the surgery. I'll post when I get more information, I'd planned on calling Aetna and PMRI about coverage for the $1200. The way it's listed I'm not optimistic. Karen