Program Fees???????????

My insurance I have right now Optima Family Care covers the weight loss surgery which is great and I wouldlove to move forward but the only thing standing in my way is these program fees that are charged seperatley and not part of the charge from insurance.  They say I have to pay it up front on first visit to start the process.  Thomas Clark practice charges like $695 and Dr. Fontana office charges $495.  So I guess my ?????? is, is this standard with all Dr. for these the fee or are there ones I can go to and not pay this fee.  I know when it comes down to it that's not alot of money considering the total cost of the surgery, which by the way I would like to get the lapband but for my family right now we have no money and just struggling and I would like to take control of my life and weight with this surgery so I would like to get it ASAP, I'd go tomorrow if I could lol.  Are there any Dr. in this Hampton Roads area that doesn't charge that fee or less or does payment plan that I can go to????? Please help!!!!!!!!!! Thanks, Kerry

My Dr charged $350.00 for the sleeve.   I have heard some drs charge as high as $3000.00 for revisions.   

Sorry my Dr is in NOVA

Tyvm for responding. $350 does sound better too bad it's too far away lol.  Yes I have heard it can cost in the thousands for the fee and it wouldn't be so bad if I didn't have to pay all at once on my first visit.  If I could make payments then I could start right away but now I have to wait to get this money before starting my journey, seems like there is always a roadblock somewhere lol  Take care, Kerry

I was bill after the surgery.    Keep in mind too that not all of the surgery may be paid in full too.   I Depends on the type of insurance, deductables or %age to be paid. 

Nutrionist fees at the hospital as well.   

I am in Richmond and went to Commonwealth Surgeons Dr. Neil Hutcher. $0 program fee. It is farther from you, but you might want to consider. Just so you know!

I had surgery with optima family care, my surgeon does not charge a program fee at all.  He does open surgery though, so if you arent wanting that than I guess that would be a good option.  If you want PM me. My surgeon is excellent and I got approved and my surgery date was with the next 2 weeks, I had to reschedule it, and I was still done in the same month.

WOW that was a quick process.  Did you do preop testing, psych eval, and a pre-op diet?

Hi Lauren, I did pre-op testing, met with the nutritionist and had a psych eval as well as meeting with the bariatric coordinator at the hospital.  My doctor didn't require a pre-op diet, but suggests we make changes to get ready for our new life.

I think we had a poster recently saying another doctors fee was $2000.  So, if comparing to that, you're getting a bargain at $495 or $695.

I know this seems like alot of money, but you are exactly right, when you factor in the cost of surgery and the cost of aftercare it's a spit in the bucket.  Though I think the aftercare of Lapband would be cheaper.  As an RNY patient I have a monthly expense of vitamins and protein supplementation.  Also, think about the weight you would lose and your need for new clothes along the way.

Research the surgeon and their office and credentials, you should go with statistics and not worry about the money so much.  You want to make sure your surgeon has performed alot of your surgery, has a zero or very low complication rate, that the surgical office is a center of excellence.  All of these things are worth an entrance fee.

On a personal note, I don't agree with the entrance fee's, I think it's just another way of doctors circumventing the healthcare system and trying to re-coup costs.  BUT it's the way it is and if you have found a good surgeon I would set the money aside and go for it.

Good luck!

What Caroline mentioned is VERY true.  The program fee will/may  not be the only costs you are responsible for.  Check with your insurance provider on if the surgery, doctors fees, hospital stay, anesthesiologist, preop testing and psych eval's are covered and if so, what percentage do they pay.  To give you an idea of cost.  My RNY was billed at $47,000!  The maxium allowable benefit was $27,000 and that was 100% paid for the surgery, doctor and hospital stay.  I was responsible for 10% of the anestesiologist and I think a few minor things.  My total portion came to $900 plus an initial co-pay for my consultation appt.  And this is with VERY good insurance.  I remember the hospital insurance intake person was a little taken aback by my insurance.  She said to me "I look at insurance plans all day and your husband has a very good insurance plan".  I would wager to say her comment and my experience with other insurance in the past is that employers go the cheap route which means less will be paid, higher deductibles, higher co-pays, etc.

I hope this helps.