Lap-band Fills

Kristen C.
on 6/25/08 12:06 am - Boston, MA

I'm having a nightmare of a time with insurance and the fills.  I had my band placed in December of last year at Tufts NEMC and was told all fills would be treated as office visits (thus requiring the office visit co-pay).  Well, since they're affiliated with a hospital, it's coded as outpatient surgery (which for me is a significant cost - about $200/ fill).

So, I've been working with the insurance company and the hospital to work it out.  Ideally I'd like to continue going to the location that placed my band.  However, I was wondering if anyone knew if there were surgeons in/near Boston that do fills on patients that had their bands places elsewhere and code the fills as office visits instead of outpatient surgery?

Thanks for your help!

Kristen

NeedhamGal
on 6/25/08 2:49 am - MA
can you ask that they code the fills in a certain way? I do know the insurance industry as issued a insurance code for this procedure.   I have had 2 different insurances while I had the band.  When I had blue cross it was seamless. When I had Cigna they would pay for the office visit part, but not the fillpart of the visit (go figure!!). good luck navigating the system. Joan
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