Interested in what a revision would cost out of pocket

Hi Everyone, I am currently waiting to find out if my insurance will cover my revision, but do not think it will. I am looking into alternate ways to get this surgery paid for. Does anyone know approximately how much it would be to go from VGB to RNY [including everything --preop/postop/surgery/revovery in hospital] I am trying to come up with a backup plan and want to have a pretty good idea of what range I will need financially. Has anyone ever heard of the surgeon's office giving a reduced rate for self pay patients. Any info would be greatly appreciated. Thank you so much Mandy

Hi Mandy, I haven't had a revision but know that the doctors and physicians should be open to a conversation regarding reducing their fees. If you think about it this way..... most doctors that preform this surgery are in network with managed care companies. That means that their reimbursement is significantly lower than the gross charges on the bill. In example, the total of my surgery was $50,000 (not revision just RNY). The actual ins company reimbursement was $6300 to hospital, $2000 to surgeon, $1000 to anesth, and smaller amounts to specific providers of services (lab, rad, pulmonary,cardio). Knowing this, any doctor office that knows their business should have a discounting program available to those who do not qualify for ins coverage. Most charges are based on a fee schedule for a geographic area that is inflated to reflect cost and reimbursement for the region (i.e., pharm charges for drugs 4.00 for tylenol), and depending on where you live these prices are different. Sorry, started to ramble..... I would ask them if they would honor the price that your insurance carrer would have paid or that amount and a reasonable and customary percentage. There should be something that is available. Oh, and if you look up local insurance and banking sections of your goverment there are intiatives to stop medical providers from collecting 100% of charges from un/under insured people, it is not only bad PR to charge someone 100% of charges when most reimbursement from insurances are so low, but if you think about it, its unfair to those who have to pay out of there pocket. Just something to think about, if armed with the correct information you could go in with info that would blow their socks off and they won't be able to smooze you. Also, the case rates for surgeries are not necessarily based on procedure. It is based on time in the OR, what kind of bed in the hospital, or what time the medical professional spent with you. You could perhaps ask how long would it take in OR, would it be a med/surg bed or ICU in the hospital and then find out what the ins company would pay on those charges per day or time frame. Calculate it in that fashion. Sorry, went off rambling again and please excuse the typos..... Hope this helps and if you need more info feel free to drop me an email. Val~

I'm not sure I would take this for the final answer, but when I spoke to the very snotty receptionist at Barnes Hospital Bariatric Unit, I was told, that the Dr.'s only review revision requests once a month and if you were selected and your insurnace would not pay it was 40,000 out of pocket with a minimum of a 10K down payment. As I said, this receptionist was very unpleasant and was doing her best to discourage me. I guess she was having a bad day but she didn't discourage me, only made me that more determined. Hope this gives you a general idea of what they would charge. Now what they will accept might be a different story.

Barnes is supposed to be having a surgeon that is dedicated to revision but I believe he is going to be highly selective. There are other surgeon's in the midwest that do revision's from the proximal to the distal gastric bypass....Dr. Chua in Milwaukee and there are several in the Chicagoland area that also. If you need contact numbers I know that many of them are on the obesity help website. As for insurance coverage that varies from one insurance company to another....usually have to have documented proof of a SLD or a fistula from the new stomach pouch to the old stomach or an enlarge stoma. I was lucky and my insurance covered my surgery....it ended up costing over $65,000 with all the complications I had. I also had to foot the bill for being on tube feeding formula and supplies which cost over $500 a month. Good luck.... Dawn

Hi So Happy, I had a revision from the vbg to rny(lab) and the cost of my surgery was 37,000.00. I was bless that my insurance paid for the hole thing. I have and had PacificCare hmo and I was aprroved with in two weeks. I wish you the best in your weight loss journey. Take Care Jc C.