Large out of pocket expenses?

I just had my consult today with Dr. Christopher Boynton and was rather surprised to receive information from him that stated I had to join a bariatric support group that will cost me $2100.00. Apparently this group fee will include my psychiatric and nutrition eval but I have insurance that will cover those things without me having to pay for them. I asked the nurse coordinator if I could use my own providers to do these evaluations and she told me that they only use their bariatric program. Also, it looks like even those who submit the bills for reimbursement with their insurance companies aren't having any luck getting repayment. I have all the resources available at the hospital where I work to get this done without out of pocket expense-this is ridiculous. Does anyone know if their are any bariatric surgeons(preferably southern or central New Jersey)that allow their patients to use their own specialists for evals to avoid exorbitant out of pocket expenses? Any info is greatly appreciated. Laura

Laura, I had about $700.00 out of pocket forthe psyc ect which I am going to submit. Not sure but I think the psyc is covered as he was in my network. Lot of the bariatric centers are like that. The wish center in Florida wanted almost $5,000 up front when my sister went to consultthem. Part of a lifetime membership. Now they have closed in Tampa and I am so glad she did NOt use them! She is on medicare and on a limited budget so there was no way she could afford it. I had seen some of their patients on the florida board complainind they had to pay aobut $1,300 for a so called lifetime membership and now it is no good to them. So be careful, I used Dr Boeoa at Monmouth Medical and so far not tons out of pocket. I work at Meridian in Red Bank and there is no longer a doc doing the surgery wihtin the healthcare system so I had to go to them. They paid all but $ 10.88 pf hospita; (qual care) which Iam going to appeal because there was noone within the Meridian system now the one guy left due to malpratice inusrance and I am SO glad I did not use him than God! Anyway, be careful and I wish you the best JOycelyn

I think support groups are vital to our success, and I've attended three different groups in addition to the one at my surgeon's hospital, and all of them (so far) have been free. At this point, I think the doctors who mandate support group membership and charge fees for it are in the minority, but I expect that it will increase. I'm not aware of any insurance co. paying for support groups. Without actually experiencing the $2000 group, I can't advise on whether or not it's worth it. I can say that post-op support is critical. Pre-op knowledge is important too - make sure you educate yourself about surgery. I consulted with three different surgeons before I had my surgery; two had people to recommend for the pre-op clearances, and one had people to use actually stationed in his office. I used my surgeon's recommended shrink, because I don't think all shrinks are equally familiar or capable in the area of WLS related issues, even though she was out of network. I also used my hospital's nutritionist -- luckily, she turned out to be in network. However, I did use an "outside" cardiologist, gastroenterologist, and anasthesiologist for my heart clearance and endoscopy, respectively, and I made sure they were all in-network for my insurance. I still had co-pays but it was much more affordable. Ultimately you should have your surgery with a surgeon whose abilities you feel confident in and who you feel best prepares you for success. I always recommend consulting with at least two surgeons/surgery teams before making your decision. Good luck, Jen

Laura, Having been a "successful graduate" of Dr. Boynton's program, I can assure you the $2100.00 is worth EVERY penny - if you utilize it and follow the program. To anyone *****ads this and is still pre-op - I CANNOT STRESS ENOUGH HOW IMPORTANT IT IS TO HAVE PROFESSIONAL SUPPORT TO SUCCEED WITH THIS SURGERY. First of all, in my opinion, Dr. Boynton is one of the best bariatric surgeons in South Jersey and you will have a hard time finding anyone who has a better record with lack of post surgical complications. As for his pre/post surgerical care program, New Beginnings, I can't even put a price tag on what those wonderful people did for me. I attended their meetings 5 months before surgery and then participated for the full year that's required post surgery. As well as getting your evals, which your insurance might cover, the program also gives you weekly nutrition and support group classes, manned by professional nutritionists and psychologists. Each person is assigned a case worker (registered nurse), who are the most supportive, kindest ladies I've ever met in my life. They laugh, cry and get angry with you and will also hold a very dear place in my heart. You are also given a very detailed 8 week food plan and well as a specific vitamin regimen to help you re-introduce foods to your new stomach safely and in a healthy fashion. Thanks to their help and the unflagging support of those in the support group, I lost 190+ lbs in 1 year and thanks to the monthly 1 year post-op support group meetings they also offer, that I attend, I've kept it off for the past 10 months (my two year anniversary is in May). I've met lots of people in the past 20 months who have had this surgery and none have had anything comparable to what New Beginnings offers. I know, for me, I never would have done as well as I have, if not for this program and it's incredible staff. So, while I can't guarantee you'll lose all your weight if you pay up the money and join the program, I can tell you if you do, you'll have the very best surgeon for this type of operation and IF you follow the program, you will see very good results. I hope I don't sound preachy, it's just being on the other side of things, I can tell you, this program is worth the money WITHOUT A DOUBT. My husband and I had the surgery on the same day, so we had to shell out $4000.00, which killed, as we'd just bought a new house a few months earlier. While I still don't have new furniture for that house, we have two new healthy bodies in it and that works for me! As for paying for it, there's a couple things you can do to re-coup a bit of your money. You're right, your insurance (unless it's ultra liberal) will not pay for the New Beginnings fee. However, if you company offers a Flex Spending plan, most will cover weight loss programs. I signed up for the max amount allowed (then $1500) two years in a row - paid the down payment, and paid off the rest monthly, using my FSA - so while it was still money out of my pocket, it was pre-taxed and taken out each pay, instead of just handing over $4000 at once. I know NB does have a payment plan, so you might be able to work something out. If you don't have an FSA plan at work, weight loss programs are tax deductible, so you can claim it on your taxes, you'd just turn in your receipt and a note from Dr. B explaining the necessity and requirement of the program (he wrote them for me for my FSA plan - no problem). While I understand the money issue involved, I do hope you'll really consider the alternatives. Going it alone is very hard. While I balked big time at the price when I first heard it, I also knew I would pay whatever it took to one - get Dr. Boynton to do the surgery and two, get whatever help I could to make this work. I've spent well over $2000 in my lifetime on Weigh****chers, NutraSystems, diet pills, etc, so I decided it would be the last time I had to spend that kind of money to lose weight. I wish you lots of luck in your search and hope you have great success. Please feel free to e-mail me with any questions regarding New Beginnings or the surgery in general. Denise RNY 5/6/03 264/176

Denise, I am sure your doctor is great like I feel about mine. I think all should be aware they need to check out the doctors and the program they offer. As i said my sister would not have a support system had she used the WISH center and they are all over the US. I also did not use the doctor within the healthcare system I work for as I had seen negitive post about him on here. Plus one of my doctors warned me he had malpractice problems. I hope you do not think I was saying bad things aobut your doctor I was just trying to stress the importance of knowing ALL about the doctor and program especially if you have no medical knowledge. A lot of people have jumped into this surgery withiut ever questioning the do;s background ect. I am glad you and your husband have done so well! that is great! Do you ever go to Columbus Market in SOuth Jersey rt 206?? I have seen some good buys there on furniture. great place for produce! JOycelyn

No offense taken at all Joycelyn. I agree 100%, it's very important to research for both the best surgeon and a great after care program. Getting a great surgeon is only half of what it takes to succeed. The other half is getting the right kind of help to break through years of bad eating and exercise habits/eating issues. My doc did have malpractice problems, but they were caused by an associate in his practice, not by him personally (that doctor no longer does bypasses). This is a great example of what you said about researching. Just because one doctor in a group of bypass surgeons is good, doesn't mean ALL of the doctors in that group are. Like Chris Rock said at the Oscars, if you want the best - WAIT for the best. Don't go with someone else in within the group (assuming he/she is just as good), because you don't want to wait the extra 6 months for the you know is the best. 6 months beats dead any day! I have been to Columbus Mart - love that place! I miss the race track market - that use to be lots of fun to go to. Now that I can buy "normal" size clothes, my husband and I are big outlet shoppers. Quite the irony, I use to do all his clothes shopping for him, because he refused to shop - now he suggests where to go! Denise RNY open 5/6/03 364/176