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

This is for others reading this since the OP deactivated...

As I mentioned in my previous post, mine has a $3000 fee and what it covered...

Now my surgery was covered at 100% (minus the program fee), was billed 60K from the surgeon and the hospital together. Of that 60k, only 15k was allowed to be paid. I believe my surgeons portion of that 15K was less than 3k. So for the most time consuming procedure there is for a virgin wls, he ends up with 6k and I got the surgery AND a years worth of followup visits, regardless of how many times I need to go in.

Now if he had gotten more of what he billed, I'd be more outraged but all I did was try and get the breakdown of what the fees covered and tried for reimbursement from my insurance carrier. Btw, they ignored my claim. I really should be madder at them than my surgeon.

Liz

well by reading these post , I guess i am paying alot for mine, however i love my doctor and i want him to do my surgery. I have a $500 program fee, gotta pay the Nut $200 for my 3 months pre op regimen, pay a co pay to see the doctor everytime during the 3 month regimen, pay a co pay for the therapist, and will pay a co pay for every visit after surgery. With that being said, the NUT and therapist attend the monthly meetings and are available to help. My insurance will cover 90% after a $400 copay. This does not include the hospital stay,

My point... well if you want great treatment and medical care, you have to pay for it. I am a nuclear medicine technologist, and i am worth every bit of the $35/hr. I busted my ass to be able to get a career. Just cause ppl cant afford  quality health care doesn't mean the doctors or nurses should do it for free... rem college don't care if your broke! so no one had empathy for the doctors when they wanted to pursue their career.

Sorry couldn't resist responding even if a little late!!!
Here is my .02 cents and experiences all for free!
I have no sympathy for the insurance companies. They tell the doctors how to treat patients based on $$$ instead of what the doctor knows based on their "professional" knowledge we need. With that said, I will tell anyone still reading this my experiences with wls and insurance companies.
I had insurance in 2000 that covered my RNY surgery. I paid the Dr who practiced 1,000 miles from me (yes I chose to travel to get a very good doctor) paid his upfront fees of over $2500. That was my choice. I had the surgery and the in network hospital charged the insurance $13,000 for a 2 day stay and surgery. My insurance paid them a $3000 negotiated amount. Since I lived so far away all my after care was done by my PCP, which I paid co-pays, etc. My RNY doc stayed in touch by phone, internet, mail, etc. About 18 months later, my insurance company sent me a letter and it said..."oops we over paid for your wls, you owe us $5000 in 30 days or else". I was in shock...I thought why wait and tell me this when I could have known up front and paid the bills. I don't think my insurance paid much more than that all total for the procedures. So, I contacted my RNY docs office and they let me know that was illegal and how to proceed. I followed their instructions and a week or two later, I got a very long appology letter from the president of the insurance company telling me they made a mistake and that they were very sorry. INSURANCE companies are only in business to make $$$$$$$, on the other hands DOCTORS are educated to heal and treat diseases and they need to be compensated....they are in the business of caring and treating people. BIG difference. Now, fast forward to today! I have insurance with zero wls coverage...oh they think it is medically necessary they just chose to NOT cover it because it is no included in the amount of the insurance paid each month. So, I am needing a medically necessary revision and will be self pay out of pocket somewhere around $30,000 and I am going to pay that and go to the best revision doctor I can.
INSURANCE companies are not being hurt by this. INSURANCE companies are not mad because of this. INSURANCE companies do not care about my health. INSURANCE companies do not have the ability to decide what is best for my health. They take your $$$ and then choose what they will allow based on how much $$$$ they can make. In no way is the INSURANCE companies are not the victim. Take a look and see who is doing what is illegal and getting away with it out there. More times than not you will see class action lawsuits against insurance companies. Whew, I feel better now!!

I would have gladly paid $4,000 instead of $25,000 I paid for my surgery.  I bet there are many of us self-payers that would jump for joy to have insurance that would pay anything.  Do I regret spending the money, hell no it's one of the BEST investments I've ever made.

 Those are my sentiments exactly.

If I could have paid a mere $4K, for a surgeon of Dr K's caliber, all the better - I'd have been thrilled.

I am in a program that doesn't charge a fee, but there is one in the area that does.  I think its $500. But I am in this program because of the Dr.  He does not use staples to do an RNY and there is not a Dr in the area that does DS.  All I have to pay is the CoPays for all my dr visits and thats for the Nut, the Psych, Dr. Spencer himself and whatever else.  Plus, his program requires a membership to his Post Op Exercise program and that $120 for 6 one-hour sessions.  There are other requirements he has but all of that will be paid with my copays.  I go see him on the 6th for my one-on-one....  

There are TWO DS surgeons in NC, only one of whom I personally would use (Sudan at Duke).  Most states don't even have one.  Your reason for not considering DS is ridiculous.

I am in a location within NC that all of my Drs are in Virginia.  I do not have the resources nor do I want  to drive to Duke for something that I am not interested in. 

I have done my research, considered all options,  talked to people and I do not want the DS. Sorry you think  my reasoning is rediculous. Thats not the only reason I am deciding against the DS.  Its one but not the only one....

I sat and watched this thread get...intense to say the least. I see the OP's point, but I think she went too far with her claims of irate insurance companies and news media coverage. I think if the issue is looked at with complete neutrality, then the OP's position gains a bit more understanding. This fee can't be compared to what a self pay person paid. This fee should only be compared to what other vetted DS surgeons charge for their program fees. It kinda goes without saying that a self pay person would rather have paid 4K for a vetted surgeon rather than the 20-25K s/he paid. It seems kind of harsh to bash the OP based on what is included IN the fee. Insurance patients will have their follow up care paid for by insurance. Support groups can be had at local hospitals for a fraction of the cost. NUT visits COULD be covered by insurance, but in the event that they aren't..NUT visits once or twice a year will not reach 4K. If this surgeon is answering calls personally that is sweet and all, but PLENTY of patients do just fine with surgeons who dont man the phones or run support groups or personally answer general emails. So what is included in the fee is a moot point  because for most people insurance will take care of the bulk of the aftercare visits. I suppose its a great safety net for a person who is not sure of continued insurance coverage and it is obviously a steal for a self pay patient but for a person with relatively decent insurance, follow up visits aren't a strong concern.

I think what isn't CLEARLY, and without snark, being said is that people are very passionate about keeping the very, very few vetted DS surgeons in business so that people will CONTINUE to be able to recieve this surgery. So I think what isn't being CLEARLY stated is that we need experienced, vetted surgeons to stay afloat and keep performing this surgery. We need this surgery to remain an option even though the insurance companies don't make it worth a surgeons while to perform it. So extra costs above and beyond what insurance pays is a small cost to keep a very skilled surgeon in business taking on the sickest, and most dire patients. Fortunately, it hasnt gotten to the point where EVERY DS surgeon MUST supplement their fee with a 3, 4 or 5K fee.  That fact alone goes a long way towards buttressing the OP's position. Again, the added drama about livin insurance companies, potential media coverage and taking on a fight for "others" was a bit over the top\

Edit for clarity

My program fee was $290. There's no way I'd pay $4,000!