US Bariatric of Florida Costs?

Hi, Anyone who used US Bariatric of Florida either in Miami, Ft Lauderdale or Celebration who can help would be greatly appreciated. I am trying to figure my out of pocket expenses for surgery with Dr. Kim. I have United Heath Care POS which will pay 60/40 with a $500 deductible. I know that there is the $600 program fee (does that count toward the $500 out of network deductable and what were your fees for the surgery with Dr. Kim or Dr Marema? I will be covered at Celebration Health Florida Hospital at 100% minus the $500 deductible there. So far I am looking at approx. $4,000 on my own. Is that what others have paid? I just want to be sure that I have all my funds up front. Thanks in advance for you input! Lori

I had UHC and had US Bariatric. I paid for the psych eval ($400), program expense ($600) and my hospital deductible.($250) I had no other out-of-pocket costs related to my surgery (12-15-03). The program fee, as I understand, is for non-medical materials (the BIG book, tapes, orientation, etc.) and visits during the 1st yr. It was not part of my deductible. I had Dr. Perez. He's wonderful...........the whole group is wonderful. You have made a good choice and your money spent is a wise investment into your health. Let me know if there is anything else I might be able to share. Ruthanna

Hi Ruthanna, Thanks for the information. I appreciate it. Thanks, Lori

Lori, I had my surgery 1/19/05. Cigna is my insurance, they pay 80% I pay 20% up to $3000.00. I paid $2500.00, which was half the surgeon fee because it was estimated that Cigna would pay the other 50%. (This payment was in 04 because I was suppose to have my surgery in 04) I paid $614.00 to the anethesiologist because he sent the bill in first so my deductable went to him along with my 20%. I paid the hospital $1200.00 the day of surgery and $1014.00 after surgery. I paid over the $3000.00 out of pocket max so the insurance company picked up the rest. They even paid the entire $5000.00 surgeons fee so I got money back from U.S. Bariatric! Good luck! I adore everyone at USB. I think it's one of the strongest, most comprehensive programs around. Rhonda

Hi Rhonda, Thank you so much for this information. It is very helpful. I believe that my cost will be a little higher due to the 60/40 out of network fee. If I have any other questions, I'll email you. Do you go to the support groups on the 2nd Wednesday of the month? I would love to meet you at some point and time. Thanks again, Lori

Lori, Hello I am at that finacial side of the celebration health and insurance also. my insurance is aetna and I have 70/30 coverage so this is what I have found. Total cost of the laprosopic procedure is $5000(only for the Doctor) You insurance decides how much of that is resonable and customary for instances my company says only $4000 so that is the amount they will pay 70% of, My insurance also has a $250 deductable on top of that(for the doctor) The Program fees for before and after care is NOT included so add on $600 for that. so for the doctor Alone: 70% of $4000= $2800 Program fee= $600 your not going to believe this but i just git back from the emergency room via the ambulance I have been gone since 7:00am. and it is now 10:20 (hernia was strangalated and through God"s mercy it went back in) I am getting this weight off) as I was saying: Doctor deductable $250 psy evaluation $400 Hospital is covered in my plan(deductable) $100 $4150 They have financing through www.creditcare.com good luck meechi

Thanks Andrea, That really gives me a good starting point. How did you get the insurance company to let you know the reasonable and customary fee? I've called mine twice now and the 2 people I've talked to say to go to the website and go to the surgery calculator. The problem is that WLS is not one of the surgeries listed and the put the total cost of the surgery in it; not just the surgeon. When I spoke with Karen at US Bariatics, she said I would need to find that out for myself. Any suggestions, did you have to find out this information yourself from Aetna? Sorry to hear about your trip to ER. Hope you are better. Glad the hernia went back in. Wow! what a day for you. Lori

Hi, I originally started off with Dr. Kim's office, but Karen couldn't seem to get the usual and customary amounts for my Cigna benefits. She is a wonderful person, but I was having problems with her as a coordinator up to 2 weeks before my scheduled surgery date. I had to switch to Dr. Overcash in Ocala at the last minute. His insurance coordinator had everything she needed from Cigna in an hour. So, maybe it's just Karen. I don't know. I hope you have better success. I was very impressed with Dr. Kim when I met him, but I love Dr. O. I do want to go the Celebration meetings because Ocala is too far. Can anyone give me any information on meeting times and room numbers? Also, I have a friend that is interested do you know when Dr. Kim will have his next information session? Thanks

Hi Tiana, I've also decided to go with Dr. Overcash at this time. I got a call from Karen today to say that I have to use their psych consultant and she is $400, when my insurance company found a doctor in my area who does bariatric evaluations and is only going to cost $61 to $81 total. I was astonished that they said I could only use their person. I was the straw that broke the camel's back. I was so angry at that. It was already going to cost me approx. $3,500...now that is an extra $400. I also thought it strange that Karen couldn't give me the information about the fees from the insurance company. I am working very hard to save this money up and I didn't want to get to surgery day and find out I owe $5,000 or more for all the expenses. I got on the phone after reading several profiles over the past several months and called Dr Jawad's office and Dr. Overcash's office. Patrice answered the phone and I left a message at Dr. Jawad. My problem was that both docs are on my insurances as surgeons, but Ocala Reg. was not. So I noticed that both had also used Munroe in Ocala and that hospital is on my insurance. That means that most of the cost is covered. So I have an appt to see Dr. Overcash on Mon., 5/9 @ 1:30 p.m. I really liked Patrice. She said at this point I don't even need a psych eval. I'll know more when I have the appt. She also discussed that she felt with my insurance and where I work it won't even be a requirement. Imagine that. Dr. Kim requires it no matter what and my insurance and employer don't, very interesting. Makes me wonder what else was being required that the insurance doesn't need. Any way, I will be going elsewhere like you. Dr. Kim has seminars every Wednesday evening at 6:30 p.m. at Celebration and the 2nd Wednesday of each month after the seminar there is a support group meeting which is also required to attend. Their phylosphy is great, but they are just too expense for me. Especially when the doctor isn't a preferred provider for any insurance and you have to make up the difference if what your insurance usual and costumer fee is less than what his fee is...so even if you pay 60/40, that's not enough, he is going to get his full $5,600 one way or another. The $600 is the program fee that is non-refundable (so, don't change your mind). Sorry for going on so long. I was really mad today! Lori