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

You might want to look at yourself in the mirror when you consider that "criteria" thing.

 This is a bit OT, but I don't believe basic healthcare is a privilege of only the wealthy;  everyone has the right to healthcare.  Especially when you look at the statistics showing the ways in which poverty contributes to the disease. 

That said, a surgeon has the right to charge whatever they want to charge.  DS is a more complex surgery than the RNY, but insurance won't pay more, so the consumer gets charged more.  

 Yeah, I wasn' t referring to universal healthcare. I was referring to Dr. K asking for a program fee. No, I don't feel like everyone should get a ds just bc they are overweight. just cuz. lol. 

I paid a program fee but it was way less than that. I could'nt believe that I read that in your post.4,ooo..sheeesh.

I paid 350.

I Know, Right?
It's like paying $2,000.00 for a diamond when I could have paid $25.00 for a cubic zirconia!
Go figure!

Like totally, right?

I  you, edeldog

You paid a $350 program for to a LapBand doctor?  Those guys (gals) are a dime a dozen!

Not so with DS surgeons.  It may just be a supply and demand kind of thing.

I have a difficult time believeing you spoke with four insurance companies that were "LIVID", bc do you have four different insurance companies you have current policies with? Usually you need an ID number to even speak with a rep, if you thought the MD was being fraudulent this is not for a customer service rep to get "LIVID" over, its for them to take the info and refer to their provider relations dept for review.

I would select a different program with no program fee, save the $4000 for behavioral health co-pays bc you are way too sensitive as well as nasty to a group of people who tried to help. You must have some issues.

Good Luck.

I used to think the program fees were a big ripoff. But what I discovered is that WLS isn't like other surgeries. When I had my gallbladder  out, I met with my surgeon twice, once pre-op and once post-op. I don't think I saw him in the hospital at all (or maybe I saw him once --it was 22 years ago and te memory fades). There was no follow-up after the initial post-op appointment. Basically, he cut me open, sewed me back up and was done.

OTOH, I see my WLS surgeon almost every month, sometimes more. I see him at support groups because he runs them. I see him at my follow-up visits of which I've had many. (Many more than advertised in the post-op guide.) I also had free access to the NUT and the counselor for 2 years after my surgery. (Insurance would NOT have paid for those visits, only the pre-op visits were covered.) There's also a newletter that comes out 2x a month and some other random crap I don't care about.

If I had gotten a band, the fee includes unlimited fills and unfills without co-pays. Some insurances don't cover fills at all and most have a co-pay that precludes getting them as much as some people need to.

The bottom line is: insurance companies know about the program fees. They are set up so that the surgeons that charge them aren't inviolation of their insurance contracts. So your choice is to go to the surgeon you want to go to and pay any fees he charges or to find a different surgeon who doesn't charge them. Well, I guess you can post indignately on the internet and insult anyone who doesn't agree with you will calling *them* rude, but it's not going to get you anywhere.

In my case, I didn't have to pay a program fee because WLS wasn't covered *at all* by my company. So instead of $4000, I had to pay $17000. I think that's a much greater injustice than a program fee which can easily be avoided. WLS exclusions are completely unethical IMO. Program fees are in a gray area but not providing medical care at all is not.

Um, well, $4K is a hell of a lot less than the $19,200 I paid.

Yes, it is legal for him to do that. I am less than thrilled that is so, but for HIM, at least, I have some empathy. He does amazing work on the most complex and risky of patients, people that no one else will touch even if they DO know how to do what the people need (and hardly anyone does on a good many of them). Go find out what he gets paid by your insurance for doing that.

I know why my former housemate got her DS with Dr. Greenbaum, Medicare reimbursement was $1,800. Try running a practice on 3-5 of those a week.

There are other surgeons who do or don't charge program fees. Dr. Greenbaum, to stay with him (and he IS an option for you for your DS, even though he's in NJ--many if not most of us traveled for our procedures) will charge you a couple hundred bucks at most. That includes the supplies for his mandatory preop diet and lifetime membership in their support group, both 3d and virtual. He might not even charge the whole amount for out of towners.

My surgeon, Dr. Peters, used to charge a flat fee for his services from preop to one year postop. If insurance didn't pay it all (and it was ridiculously low, like $4K or less total--dang, hard to remember details this far out LOL), the patient made up the difference. He was a solo practitioner whose wife, an OR RN, managed his practice and did a lot of the non medical advising of patients. You could give him a call and see if he's back in the OR. (He took a lengthy sabbatical due to illness.)