Are Program Fees Normal?

Ok, so I'm looking into to having the lap-band surgery once again. Everytime I get gunho about it I'm discouraged by progam fees. Most of them say the fees are for administrative work...ie their job? I really want to do it but I just don't have an additional $500 to $1000 on top of the 10% that I'll have to pay out of pocket with my insurance. I've been to two doctors so far and both have had them.  Are there any doctors in the DMV area that don't charge the fee or is this just normal practice and I should just start saving up?

This is pretty common practice, because nutritionist services are frequently not covered by insurance, and if the program is offering nutritionist visits for 3 or 6 months plus the presurgical and post surgical diet instructions lectures, they charge a fee to cover the services in advance.  Or some allow you to pay in installments but it has to be all paid up before they will schedule you for surgery.  Best of luck to you.  I know that Dr. Von Reuden, now at St. Agnes, GBMC and Johns Hopkins all charge a program fee for the supervised wt loss program.  Hopkins has different fees, one for the 6 mos and one for the 3 mos, depending what your insurance requires you to do. 

I have Dr. Averbach (St. Agnes Hosp) and I only had to pay $150 on top of everything else...That was for a year of "service" paid to the nutritionist after surgery.

The program fees cover any number of things, including nutrional services as well as support group follow up, etc.   What you need to realize is that the insurance carriers have set amounts that they will pay and the the doctors have agreed to accept.   Many times the contracted amounts do not even come close to covering the costs that the doctors incur with their office overhead in providing quality adminstrative support to their patients. I think the program fee I paid 4 years ago was at least $1,500 and I think it might have been $2,500 and my surgeon told me right up front that the fee was necessary because he could not support the level of care he wanted to provide with his practice on the insurance payments.   I appreciated his honesty about that and wish that more of the surgeons would do that. Best wishes with your WLS journey where ever it takes you. Hugs, Mo

I started out with a practice in Salisbury that had a $2500.00/ upfront fee.  I was so desparate, I maxed out a credit card to pay it.  When my surgeon of choice left that practice, I decided that the practice wasn't for me and I asked for a full refund of the program fee.  I was then referred to Dr. Singh in Catonsville. He doesn't have a program fee and the only other fees I had to pay were for the dietician ($150.00 for a year's follow-up) and $150.00 for my physicological eval.  Of course there were the co-pays for the cardiac clearance,etc.  Dr. Singh is a wonderful doctor, as many will attest to...look into his practice.  Good luck.  Deb

Ok here's the thing, I might sound nit picky to some but I'm biased because I have a medical background so this is why I'm so floored by all these ridiculous fees. Doctors agree to accept lowered payments from insurance providers so they can see the most patients they can, they can negotiate those fees. Charging fees on top of that is illegal. "Program fee" is another way of saying I don't like the agreed upon rate your insurance company charges so I'm charging you more....which again is illegal. That is why I'm so outraged by this. But I guess no one else is. I REALLY want to have the surgery and unfortunately that's why they're allowed to do it because they're preying on folks desperations. Everyone who's had the surgery always says the same thing my credit cards are maxed out or I refinanced to get the money...but I really wanted to have it. That's insane.

Hi Nia!! Welcome to the Maryland Board!!  This is a great resource to have when you're deciding upon surgery!  Please post often!! When I started researching wls back in November, 2004, I went to Dr. William Roe's seminar and was immediately taken aback by the program fee of $500.  Like you, I thought, "Wow!!  Above and beyond?  That's insane!"  I also didn't like the fact that they stressed that immediately and often.  I didn't get good vibes from the doctor or his seminar, so after attending a seminar with Dr. David von Rueden, then at GBMC, but now at St. Agnes, I picked him.  AT THE TIME, THERE WAS NO PROGRAM FEE.  However, apparently, I slipped into the program just before they established a $500 fee. I share your feelings, and I'm NOT in the medical field.  Unfortunately, it seems like a program fee is now the rule rather than the exception!! Good luck, Tia

DVR had raised his Program fee right after I paid by $300.00. But think about it :  It covered all the preop visits  and  the nutritionist- If the insurance companies would start to pay for the vital nutritionist my bet is the " program fees" would disappear . I had RNY but I did notice that  Dr Mo also charges for a lapband fill- they will not accept insurance company payments but will assisit in getting you reimburrsed - I don't understand this one at all.

Hi and Welcome!! I have read all the entries and everyone has just about covered it all.  I will tell you about my experience I recently had surgery with Dr. Averbach from St. Agnes (he is Dr. Singh's partner).  There were no "program fees" however, the nutritionist was not covered and that was only a 150 dollars and covers you for six months, her name is Arlene Swantko and she is really good.  You can call her anytime and she calls right back and she will see anytime you want to see her all you have to do is set an appointment when she is there.  Believe me the 150 dollar fee is very modest and I believe if she did not care so much about the patients she could charge more.   There is always the option of having the Pshyc Consult with Bea from their office for an additional 150.00 however, I went through my insurance company and paid a co pay of 15.00 and had the consult report faxed to the doctors office. I paid one copay of $25.00 the first time I saw Dr. A and that was it.  So my fees for the surgery all total were $190.00.  Until my post up period is up at the Dr. office then I will pay a 25.00 copay each time I visit Dr. A.   If you are interested they have a free seminar each month and the Dr.'s speak along with Cathy, the RN in there office, she is also a Bariatric patient who lost 180 pounds she is wonderful also.  It is good that you are checking around.  Hope all this information you have received is helpful to you. If I can be of any further assistance PM- me. Have a great day!

hi. I am seeing Dr. Roe and his program fee is $500. He says it's to cover extra costs like the information seminars and group meetings (which he personally runs) etc. He says it also makes him on call for us. When you call after hours, instead of being directed to an answering service or a nursing agency, you get sent to his cell phone. i have personally watched him drop what he was doing to help someone who was having some problems post -op.  trust me $500 is alot of money, and i had to save to have it. however, i kinda looked at it as it was my way of being committed to the plan. What was important for me is that I liked Dr. Roe, he is not a typical surgeon! and that I was comfortable with him and his staff.  good luck! Victoria