Friday Roll Call

Hi everybody!  I guess I'll start it off today!  I am angry!!!  Last night I came home to find an invoice for $325 from the local surgeon's office.  When I first contacted them by phone to ask about WLS, they said to come on in for an appointment to talk.  They sent me all the patient history paperwork and I filled out in advance and then came 15 minutes early at the appointed time.  After sitting alone in the exam room for an hour (45 minutes past the scheduled time), the doctor came in, weighed me and even though I gave him my BMI, he left for 10 minutes to go and calculate it out for himeself.  He came back and agreed with my numbers, we talked for no more than 10  minutes and then he listened to my lungs (no clue as to why, but that seems to be standard for every doctor in the world), and then he told me to talk to his office manager about how to get the insurance company to approve surgery.  I then met the office manager who told me all the stuff she would need to get the process of approval started.  A week later, after getting her all the stuff, she informed me that she had a "brief" conversation with the insurance company and that I did not have bariatric benefits in my particular insurance plan.  She then told me about a $15,000 self-pay special that they were offering and we agreed to talk once I raised the money.  That was the total sum of interaction between the surgeon and me!  So when I received this $325 bill, I was shocked.  I called to discuss it and the office manager immediately took a very nasty tone and said that the doctor spent a full hour with me and that she speant "many" hours researching my insurance benefits.  When I told her that it was in fact a 10 minute visit and a brief phone call, she agreed to adjust the bill to $225.  I said I still thought that was excessive.  She asked me what I thought was fair, and I said $50 (of which I already paid $30).  She then stated in as rude a voice as I've ever heard, "That is totally unacceptable"!  We never came to an agreement and now I have to decide what I'm going to do next.  I'm not debating whether or not the doctor deserves to get paid for his time, but I just don't think that a 10 minute sales pitch, with virtually no real information, should cost $325.  I've had hours of conversation with the patient consultant who is representing the surgeon I will be using in Mexico, and there has never been a single charge (other than my deposit for the surgery).  It's no wonder why the insurance companies are so resistant to paying for WLS!  Thanks for letting me vent.  I hope everyone has a great weekend.  Paul

Good morning Paul and the rest of Illinois! WHAT a CROCK that is!  I agree.....the doctor should be paid for his time, but that IS excessive. I suppose you could always send a bill back for YOUR time.  What is your time worth?  Did you have to take off work?  Some doctor's offices are just unbelievable!  I take it that your insurance did not cover the "consult" either?  You have every right to be angry and feel free to vent all you wish! I just sneaked on to the computer here at home to check in with you all.  I will be leaving for Madison a little before 9.  I am going to push them to do anything that might need to be done (drainage, biopsy, etc...) today, while I am already there.  We will see if I get my wish.  I love to go to Madison, but I DO have to take off work, and drive for an hour and a half each way, so it would be best if I could limit the trips. I will let you all know how it goes when I return, and hopefully, I will get to stop at Trader Joe's while I am up there! Everyone have a spectacular day!

Hey Dawn!  Thanks for the words of support.  I did have to leave early from work that day AND pay a little extra to the daycare provider for watching the kids until I got home.  I figure that these doctors are so use to insurance companies paying for everything, that they have no qualms about bilking them for huge fees.  But the truth is, we end up paying for it in huge premiums.  And in this case, my insurance wouldn't pay anything since it was a consult for a non-covered proceedure.  Good luck on your trip to Madison.  I've already said some prayers for today, and you were in them.  I'll whisper a few more throughout the day.  And I hope you do get to Trader Joe's!  They have such yummy and nutricious stuff!!!  Paul

Good Morning Paul and the rest of Illinois. Paul. Christine just told you what I would of. Plus, do you have a Dr.( local) for afterward? Yes, Dr. are expensive, especially for consults. I had to wait 3 years before my insurance would cover WLS, and then only had one option to use, A Center of Excellence. Mine paid everything after the deductible, except for the nut. Kim, waiting to see the after photos, Just remember, you will not lose weight as fast as the by-pass people, but it will happen. Dawn, I'm with you, I love Madison. Have a good trip. I am playing Susie Homemaker today. I have already cleaned top to bottom,  the "master bath", and I am heading back in there to clean the "master suite". The kitchen will be cleaned after that. I also have month end books to do for our business. We will also be going to dinner somewhere tonigh. No plans for the rest of the weekend, except to continue cleaning.  Everyone have a great weekend.  Hugs, Lisa

Good morning Paul, Dawn and the rest of my IL friends, I am feeling pretty good.  No gas , but a sneezed and coughed yesterday and felt a really hard pull.  Ever since then I am uncomfortable around the port.  I feel like it is sticking straight out of my skin.  Any thoughts??? Well...I have to worn you before you look at the pictures.  I posted some post op pix's.  They are pretty discusting.  I am hoping to post some in a few months w/ alot less fat!!  I am down to 193 as of this morning.  Also in the pictures is a picture of our new puppie.  Maddie and I were on the way to the mall yesterday and stoped by petland to look.  Well...we ended up getting a teddy bear puppie named Max.  He is so cute!!!  Maddie said she wanted the puppie instead of having a birthday party at libby lu.  Paul, I would be mad also!  Dawn, good luck today! Kim

Kim, you are so brave I wish I had the guts to do that on your pics.......Once that weight comes off you will love the before and after shots!  I did take a good shot of my butt before and one after......can't believe it's me now!    Love that puppy!   Sooooo cute Pam

Paul good morning and the rest of IL. Yeah it is Friday I have the office to myself today so I am listening to my favorite contemporary christian radio station out of Madison, WI. After work Dave and I will hop the train to go somewhere for din-din. Paul, unfortunately doctors do charge that much for a consult sometimes. You are not only paying for them to come into the room for the consult you are also paying for the time their staff spends on you, either when you are there or with other duties. I have seen $150 for just a followup surgical apt in the past. One way that you could have avoided the whole thing was by contacting your ins. co. to find out if you even had benefits for WLS. As far as the doctor's office in MX, they are jumping through hoops to get Americans to come "below the border" for surgery so they are absorbing the costs. Tread carefully with who you choose. Solicite info on the below the border forum on OH to find out if the doctor you have choosen is reputable etc. It is not only the doctor you will need to find out about the facility s/he uses and the staff. Find out if they speak English. Do not just go with what the doctor says, some are not always honest. Try not to get too upset with the whole issue, I know that is easy enough for someone else to say.  Christine  &

Thanks Christine.  I know about surgeons and all the support staff and what not, and I agree that there are many costs involved that we don't always see.  But in this case, nothing was done.  This doctor offered no more information than what is generally given in free seminars throughout the country.  That's what upset me.  Also, I did contact my insurance company and they kept saying that I did not qualify due to my low BMI.  It wasn't until later that I learned that after the bariatric group allowed for my BMI, they then identified the fact that my company had excluded bariatric benefits from our policy.  But the surgeon's office found that out in a brief phone call (brief was the word they used!).  Years ago, I had a personal/professional relationship with one of the surgeons who actually invented some of the gastric bypass proceedures that are used today.  He was a great man who never charged for an initial meeting with a potential patient.  He eventually retired because the insurance companies were paying less and less, and the malpractice insurance was costing more and more.  It got to the point where this sixty year old surgeon had to perform four times more surgeries just to make the income he made when he was fifty!  He decided that it was becoming less safe for a man his age to be performing so many surgeries in such a short time span, so he retired rather than risk the safety of his patients.  Other surgeons have found more and more creative ways to make up the money by charging unreasonable fees where they can.  It's a catch-22 situation that nobody seems to notice until they have to foot the bill themselves.  I want to make it clear that I am absolutely in favor of compensating doctors for their legitimate work.  But in this particular case, no actual work, research, etc... was done.  And thank you also for the advice about using the Mexican doctor.  I've spent several hours doing my research and found the particular surgeon and hospital I'm using to be highly reputable.  The facility is brand new and top notch.  And the surgeon is internationally accredited and has many American doctor's endorsements.  I'm still scared, but I've done my homework.  Paul

Paul, just make sure that you have a doctor in IL that will follow up after surgery. I could be costly to follow up with a doctor that did not perform your surgery.

Good morning all...Sorry to hear about the struggles Paul...not much to do about it because of the way the insurance companies are...the docs have charges and the insurance companies can give them 100 or less for an appointment that they charge 350 for and if you are paying yourself its the whole bill...that sucks... I am doing good today...had my first day back at work yesterday....it went very well...nobody could beleive I was back at work so soon...it was the first time I was really hungry since surgery so I guess I have to make sure and have healthy snacks around. I went for my first workout appt today at 9 and the personal trainer that I was supposed to see called in sick and they didn't call me. I can get in at 11:30 because I am determined to MOVE TO LOSE! I work 3p-11p tonight so we will see how that shift goes. Hope everyone has a great day!