$3k WOW! Never heard that before...

Rabkin's fee was $12K in 2003.  I had to pay $8K to schedule surgery, after fighting for almost 6 months to get Aetna to approve the DS.  Rabkin was of course out of network, but I was able to prove at the time that he was the closest qualified surgeon, and he was 51 miles away, and some weird clause in my contract required that he be reimbursed at in-network rates because he was >50 miles from me.

But of course, reimbursement at in-network rate meant using the UCR.  So in the end, Aetna paid about $7500, and Rabkin sent me a check for $3500 (the difference between my $8000, plus the $7500 paid by Aetna, which left my $3500 as overpayment).  So my DS cost me $4500 in Rabkin's fees, plus $700 for the hospital ($100 copay, plus 3 x $200 for a private room for 3 nights, which allowed my husband to stay with me and saved hotel costs, so it was better than a wash).  The unadjusted price for the hospital bill was $71K.  I think insurance paid about $50K.

I really lucked out....I was self-pay and I was expecting to pay 11 000 Qatari riyals which amounts to about $3000 USD....and when I came to pay, I was asked to only pay 5300 QR ($1400 USD) because the surgeon was now a resident and no longer a visiting Dr.

This included my hospital stay for 3 nights, surgery and anesthesia :-)

WOW!!! Great deal!

this is not uncommon, and it is not just for the DS, and is worse when it comes to plastic surgery in which reimbursement is lower,  it is in a way to ofset the reimbursment amount received by insurance co.  I actually do not agree with this practice, but I also dont agree with the low reimbursement amount the insurance co give the surgeons.  to me the patient is stuck in the middle.  instead of the surgeons advocating for more of a reimbursement they require these fees from patients, which to me is pretty sucky-just my opinion, and I do believe that if you are a contracted surgeon who accepts that insurance, you are not to bill above the contracted fee, as a provider you sign on saying you will accept the amount for reimbursement and in exchange you get the "list of patients" who will come to you because you accept that insurance.  so yes, it does go right to their pockets to offset the insurance payment they receive......

 **** I would have jumped for joy to ONLY have to have paid 3K.  I paid almost $10K!  Was it the best money I ever spent?  Hell yes, and I'd do it again if I had to.  Most surgeons have either a program fee or a surgeons fee.  It helps make up the difference between what insurance pays them for the procedure and the actual cost.  Most insurers reimburse for the DS the same they would pay for a RNY, and the costs just AREN'T the same.

ETA- just wanted to add that once the explanations of benefits started rolling in, I started a running tally of my DS "expenses".  From day one of consult, through preop testing, surgery and all it's associated costs and follow up- my insurance has been billed WELL over $100K, and paid out about $60K for it all (the negotiated accepted rate, the surgeon/Drs eat the rest of that cost).  So for me to have paid around $10K for my LIFE, out of all of that...  No problem!  I'll also say, the day I got the "bill" from my surgeon for $25K and change, I about died.  Literally, right there on the floor, died.  Thank GOD I didn't have to pay a penny of THAT one!

Question for you, did Dr S do your RNY or something? Just wondering because I know he dose the revision too. Are you in UT? If you have his "book" than you dont have to pay anything. I have a friend that had the RNY to DS just about 8 months ago and he didnt have to pay anything but what his insurance told him too. Just wondering, but yes even 3K is a lot. I paid OOP for all of my WLS about 2000, and even that was an "ouch" but I think with today's economy anything like this is an "Ouch."

I have never had weight loss surgery before.

Dr. Simper's program requires  $500 for educational fee (this fee is also billed to insurance). This office is not to far from my home and the motels are only $50 a night due to hospital discount. The motels offer free continental breakfast and have a free shuttle to the air port and to the hospital. I just can't beat that! I have called around and I have posted several posts for education on chooseing a surgeon.

Now it looks like my decision is pretty obvious! :) I am happy with my choice and can't wait to get approved for surgery!

 so by calling it a program fee they are essentially going around their contract with the insurance companies if they are contracted. 

From my years working at Aetna i clearly recall that an in-network contracted doctor is to accept his contract rate and he can not bill outside the rate to insurance patients. 

I sort of think that they should negotiate better contract rates instead of passing the fee on to the patients. 



 

If you live close to Dr S's office then why not have him do it. I had the DS doen by his skilled hands and there are a few other's on here too. He is a great Dr and I loved working with his office. I live in the Ogden area, and had my surgery at LDS, cant say that I liked the hospital, but I loved the surgen, he did my DH's RNY 7.5 yrs ago, and now he's watching both of us and seeing truly which WLS is best, so far he's going for the DS. Really Dr S is great, but as far as the book goes, NOT a fan, most of that stuff you can find on line, I do how ever like this little blue book you can carry with you that gives you ideas for HIGH protein meals. His office really is great.
Do you work for the IRS or one of the bases in the area. My friend, well I should say he's my DH's friend, his wife works for Hill, and they had double coverage and didnt pay a dime.
best of luck and keep me updated would love to follow your journy, I know that I have NEVER EVER regreted having the DS.