WHISKEY TANGO FOXTROT -- $4,000 PROGRAM FEE!!

"  Now I know why.  If he accepts all those, he can then collect $4,000 from each of patient -- on top of what each insurance company pays.

I genuinely feel this is discrimination against the obese.  Cardiac and Cancer patients are not charged fees in addition to what insurance pays. Why us? "


You are so mistaken.  Those patients you reference are turned away from 'reputable' places (like MD Anderson just to name one)  any time their insurance does not pay sufficiently large $s.  I know some would much prefer to pay an extra fee than not be able to get the care they want, where they want it.

Choice is always a good thing to have. 
You don't have to make one if you don't want, but you can't make one if a choice isn't available.

I didn't pay a set "fee" amount.  But, when you add up all my co-pays for office visits and everything, over the year and a half it took to get everything done, I paid out about $3,500.  So, the $4000 doesn't seem outrageous to me.  I am just thankful that I was able to get it done.  Part of the reason I had to wait until this stage of my life is because I could not afford my share earlier. 

Now, I guess I could have done "do it yourself"  with a fork and a flashlight out in my garage, and saved some cash.  But... I figured my doctor was worth the money.

With a little more experience, you'll be able to do it with a spork.

WOW!  I never thought about it, but I could do this for others!

Alrighty then... here's the deal...

$2000 and no questions asked, okay???

I will not be taking ANYONE who has done ANY research for themselves.

HEY!  Ignorance is bliss, right????????

She stepped in a deep pile of poo-poo-caa-caa, didn't she?  She'll be back, under another name.  I hope she doesn't annoy Dr. Keshishian in the meantime.

Nobody likes the program fees, the surgeons included.  However, they allow the surgeons to contract with insurance companies, as well as Medicare/Medicaid in some cases, which in turn allows the HOSPITAL fees to be completely covered (and they are by far and away the most expensive part of the surgeries).  And the program fees DO cover substantial services, whether or not the patient is able to avail themselves of them.  In fact, most of the DS surgeons WANT their patients to have a reason to return for the inclusive checkups and lab work reviews, to make sure they are OK for at least the first couple of years, while weight loss is going on and stabilizing.  In this case, the patient pays the surgeon's copay, the hospital copay, and the program fee - and nothing for the next two years (except perhaps lab fees).

Another model for providing services is for the surgeon to contract with NO insurance companies.  In that case, they don't do Medicare/Medicaid patients at all, and the patient has to pay their ENTIRE fee, minus whatever out-of-network coverage they have, if they have any.  Most will therefore require their ENTIRE fee, or a goodly part of it, upfront.  Then, they reimburse if the insurance company pays more than their full fee.  This is how Rabkin does it (by the way, that means whoever said that Rabkin has a program fee is WRONG - but he requires 2/3 of his full fee upfront).  Rabkin includes the two years of follow up in his full fee, so it kind of makes his FULL fee insurance-eligible, even if it never gets paid in full.  I ended up out-of-pocket $4500 for Rabkin, of his at that time $12K fee, and paying nothing for two years of checkups.

I wonder if people who get 2 years of treatment from their program fee or inclusive full fee can submit for insurance reimbursement to themselves after each follow up appointment?  Probably not, because there would be no receipt for the fees.  But it's a thought.

That's basically the way Dr. Peters did it when he was self employed. People who had insurance got assistance with submissions, and it was a one time submission.

Diana,

My apologies for mistating that Dr. Rabkin charges a program fee, I don't know where I thought I read that, just proof that I am getting old.  I will go and edit that post.

-shelly

I paid 3 five dollar copays and that was it. I would not have paid a program fee period. To each his own, do what you need to do. I have expensive insurance that covers all nut, therapist and whatever else visits with a $5 copay. My doctor does not sell any supplements and I have never been pushed any item. I believe my insurance paid well over 40k for my surgery why the hell would I be asked to pay any more? These doctors all contract with the insurance companies for the costs allowed; that is between the doctor and the insurance company. I want no part of it. And I don't want to pay more than what is seen as usual and customary, typically what asked for out of pocket is because the insurance companies see it as "excessive". I spoke with my doctor about program fees as I had heard about them on OH pre-op and he and the nurse who runs the program at the hospital thought it was insane. They said a few not so nice things about it and I just sighed a sigh of relief that I didn't have to worry about it. For those who pay it more power to you. We should all do what makes us feel comfortable and go with doctors we feel safe with…. It would make me feel taken advantage of so I would be uncomfortable.

Really? Your insurance company paid $40,000 for your VSG?  Were you in intensive care a week or something?  Cause, see, my experience is that they pay NEVER more than half of what was billed, sometimes, far less than that.  So, you're saying that your VSG was billed at over $80,000?  Wow.  You coulda had a DS for that.

$80K? More like 4-5 DS's for that.