GHP - Their Scam
On the other hand I can find other surgeons that DO bill insurance and everything EVERYTHING is 100% covered ....
I do wish I could fast forward 20 years and see how my life would play out with each of them though since the surgery war crap scares me so much that I feel sick if I think too hard about it.
What you could do is have them break down that $1000 for you, and possibly opt out of some of the appointments if you can find an insurance-covered alternative. This is how I got out of paying for the 1 yr post-op behavior and nutritionist appt, because I found one person for both, a person my ins covers.
#1) Given your surgery choice, you had many other options other than GHP (and so does your sister, if she is considering any other WLS other than the DS); if you didn't like their program, you should have opted out of it.
#2) Their system is set up to meet the requirements for their COE credentials. Research indicates that the COE credential actually means jack-crap, but most insurance companies require it, so GHP must comply with it in order to accommodate patients who want to bill insurance for their procedures. However, this is the reason for the in-house psych eval.
#3) it isn't cost effective for GHP to bill every different insurance (and get approval in advance, which all insurance requires for psych consults) for the one or two (depending on your insurance requirement -- not GHP rules) psych appointments. MOST of that fee goes to the cost to process those fill in the circle tests, not the evaluation itself -- thus you would be hard pressed to find it much less expensive outside of their system, if at all.
#4) Scott is a religious fanatic, and a douche. I warn everyone I can about him -- but people usually go along with the system and learn the hard way! Scott is NOT, nor has he ever been, the only option. He is the default, he is who everyone is always assigned to. Those who don't know any better, don't ask for someone else. I went through MMPC as well, and after my first visit with Scott, I insisted that my second psych visit NOT be with him, or I would have walked. EVERYONE I know who has asked to not see him pre-op has been accommodated. Now, he is the only option for the one year follow-up appointment, but it certainly is not a required appointment, and I just didn't book it.
~ I am the proud wife of a Guatemalan, but most people call me Kimberley
Highest Known Weight = 370# / 59.7 bmi @ 5'6"
Current Weight = 168# / 26.4 bmi : fluctuates 5# either way @ 5'7" / more than 90% EWL
Normal BMI (24.9) = 159#: would have to compromise my muscle mass to get here without plastics, so this is not a goal.
I my DS. Don't go into WLS without knowing ALL of your options: DSFacts.com
At that time, I was already seeing my own therapist. This was recommended by Scott. So I asked if she could write a letter on my behalf to save me the money. They said that was OK. Eventually, Scott and my therapist talked. She later told me what he said ... he told her he thought I wouldn't be compliant. Well, the one thing he told me to do (after talking to me for an hour nearly six months before) was to get counseling, and I did. So how does he know I won't be compliant? We (my psychologist and I) had a good chuckle over that one.
If you have to see a behaviorist there and they won't bill, just see if the insurance company will pay after the fact. Or, does your sister have a HSA (health savings account)? I know it's tough to put this money out up front (my mother paid my program fees for the protein pre-op and post-op diet and for the nutrionist and exercise physiologist visits ... I consider that a good investment in my health by her), but maybe there are some options she can explore. And if she doesn't want to see Scott, ask for someone else.