Medically Supervised Weightloss

Give the lady a break! She only spreading news some posters need. If this clinic or program takes TennCare, then let them advertise free of charge. God knows they ain't making enough money off of TennCare to pay for banner advertisement!

And what is the story about the $3000 program fee? I beg to differ with you but I feel certian they are making enough money..... Each physician/surgeon enters into contracts with insurance companies to provide services to patients at set fees. If a physician/surgeon does not feel they can provide adequate care and make a profit at the fees they have chosen to accept, then they should never have agreed to enter into contract with the insurance company and accept the patients. Please don't fall into to trap of just because a surgeon does something good for a person, that they have the right to take advantage of that person. Medical care for the most part is CONTRACTUAL and the physician is required to provide certian care in exchange for the fees that they collect. If they don't want to treat the patient then they should not take the money. Again---no one is opposed to her spreading the word about a good service. It is the avenue that she has chosen to spread her word that in the opinion of some, is in bad taste. If someone is charging a $3000 program fee, they can surely afford advertising---or else they need to take some courses in business management, budgeting and finance.

Jama: I must agree with everyone else that its inappropriate to advertise your practice on the message board. This site does have ad banners to promote businesses. We as members should have a choice whether or not to view your ad instead of unknowingly reading them as members messages. Just my two cents!

I am not a TN care patient but I would have loved to have chosen your facility, and was until you guys popped the $3000.00 program fee charge. I don't understand really why you would charge that. It seems to me that aftercare should be a part of the whole process. I have a gym membership so I didn't need your personal trainer. Yet this would not even reduce the fee at all. I can not afford $3000.00. I would have had this surgery the day after the seminar if it was possible. I feel like having to see a someone after surgery to learn how to eat or if I have any questions should be done as part of the post op care with out being charges 3000.00 I know that Dr.Boyce is a great Dr and I have heard nothing but wonderful things about your staff. I guess that is why you all will continue to charge 3000.00 and people will pay. When did insurances start paying this fee? I attended your seminar in Feb. 2004 and you assured me that PHCS would not pay the fee.

We have been working really hard with many carriers to educate them to the expense involved in offering this care. Many programs don't have a program fee like ours because the hospital provides some of the care like diet teaching etc. The do bill for it although it may be over time and patients may not know or have to pay up front. Also we have found that the system we have worked out really works, that is we have very few folks having to come back because they have such extensively available support to give consistent advice. The exercise support we are using has also been very successful. I could go on and on but the bottom line is that we set up the program to be successful and then figured out what it would cost. Of course we can't provide services for free since our staff etc has to be paid. The insurance companies have improved to the point that just this month we added several to the list where patients don't have to pay the program fee (PHCS is not one of them by the way. On the tenncare issue, it is very frustrating for us since almost no one else even tries to assist these patients and then we get bashed for trying. The interesting thing is that not all TC pays the same and each TC pays each doctor differently and not based on anything we care about like outcomes or quality. Incidentally the reason patients can be billed is because Tenncare considers the services in the program fee to be non-covered by the tenncare program. Of course we have in writing that everything we are doing is legal. All in all this is a tough business and we try to make the best of it. The only reason I can keep going is because everyday one of our post ops comes in and the improvement in their life, their relationship with our staff and knowing the next one is going to be the same, really do make it worth it. I hope this helps you to understand although I could talk on the subject all day. J Jama

Hi Jama! I can understand both sides of this issue. I understand that TnCare doesn't pay the whole amount and over time that hurts the hospital but what I don't understand is how come your the ONLY office in Tennessee that charges $3,000.00 up front from patients, whether there TnCare or not? I was going to your office until I found out about the program fee of $3,000.00. When I first got the appointment, ya'll said that fee would be fixed to your tax forms but then that all changed. I just don't see how ya'll expect a TnCare patient to even afford that kind of money in the first place -- So even know your accepting that insurance, most of us aren't able to go there due to the fees. So in the long run your winning. However, I know I could be totally wrong but that's how I see it. By the way, your NOT the only doctor office accepting TennCare any more! I just thought I'd let you know -- There's actually a few now and none of them ask for a fee nor do they feel the need to post on this board to get business. -Katie

So you will know: Vanderbilt Center For Human Nutrition - six month supervised diet - $2,100 - not refundable by insurance Centennial, Summit, Southern Hills - no program at all for pre-op patients. They will recommend you to see a dietician and a psychologist but neither of these expenses are refundable by insurance. As respects to TennCare and Aetna, the two largest health insurers in Tennessee, each look to the National Institute of Health guidelines for pre-op dieting. TennCare, while it may be more lax, has been overhauled by the legislature and one of those changes allows BCBS, the servicing insurer for TennCare to use its SOP for all procedures beginning in September. Get a life people, insurance is not the social remedy to your particular weight problem. It is there to help you pay the cost but it should not be used as an excuse for not dieting or seeking a way to improve yourself. The lady posting for her employer in Knoxville is only affording you information. For those of you living in East Tennessee, $3,000 is a lot better than paying transportation and lodging costs to drive to Clarksville to the only other TennCare doctor freely accepting patients. Again I state: give the lady a break!

And again I state, it is a cheap shot at advertising! No one cares if she post this...it may be helpful to someone, and it probably helps to pay her salary..... The point is, let them take some part of these program fees and do their advertising and patient education. Bear in mind, different insurance will cover differently based on the individual's policy. My particular BCBS will pay for the psychologist or psychiatrist. In certian situations, it will pay for a nutritionist. Vanderbilt---2100 for a SIX MONTH SUPERVISED DIET. That is for a particular service NOT associated with surgery. That is not comparable to a PROGRAM FEE that covers expenses associated with the surgical procedure. Totally different concept. I don't think anyone is trying to use insurance as a social remedy. I think that it is appropriate that people should expect that certian medical offices not take advantage of them based on the type of insurance they have. Face it, JAMA said, they sometimes charge the fee and don't others. These offices know what they are going to get paid when they contract with the insurance companies. If they have the best interest of the patient at heart, are they going to turn away patients who need this surgery because they can not afford a $3000 program fee. It is not odd that most offices can manage without charging this fee? I am glad that I am not so blind as to buy into things hook, line and sinker, without first evaluating situation and processes. Sure the docs are out there to make money--and I bet you they are doing just that. What concerns me is when they put the almight dollar ahead of the patient that needs medical care. This is not to imply that any particular surgeon/physician/practice is doing this, but it is to say that people need to be aware that health care is available..... and don't let someone take advantage of you just because you want the surgery and will do anything to get it.

Carolyn, You go girl!!! I see Jama made no comment about me already being a patient there! Dr. Boyce staff will tell you up front Tn. Care patients are on one list and other insured patients are on another list. I don't care who you are most people do not have $3000.00 lying around to hand out. Another comment just because you have Tn. Care does not mean you are a second rate citizen. We own a house, we go to church, I vol. for Girl Scouts of America, we vote,and we are on Tn. Care. Everyone has different sitiuations in life no one knows why people have the kind of Insurance they do. My husband worked 17 years on his job before he got sick and had to quit. Doctors orders so tell the politicians about Tn. Care not someone who is on it. And by the way Dr. Boyce chooses to take Tn. Care patients no one makes him so why have two lists??? Dr. Boyce and Dr. Vickers are #1 doctors in my book but...... the money deal is a little different like the other poster said NO ONE ELSE IN TENNESSEE HAS THE $3000.00 fee. Enough said! Cherry Cody

Actually Timothy my insurance covered both my dietician consults and my psych consults and will still cover any more visits that I need to make with either. Also as far as the transportation and lodging issue for the dr in clarksville. I had neither of those while having to do my pre surgery and post surgery. TNCare does provide transportation free of charge to those that need it for doctor appts. They even took me to clarksville the morning of my surgery. As for supervised diets if the surgeons would allow you to use your own PCP for the supervised diet portion most insurances would cover that. A lot of the things that are charged under these "program fees" would be covered had the patient been allowed to used doctors and such that is under their network not only the ppl that surgeon chooses to send everyone to.