Question:
Has anyone had to pay an administration fee?
In addition to all other payments, my doctor's office is requiring a (cash only) payment of $300 at the time of the pre-op class (one week before the surgery) for *all* patients. It is listed as a one-time administration fee regardless of whether or not they do the admin work for you. It sounds a little back doorish to me because of the "cash only". Has anyone else come across this? The office and the doctor are well-regarded and this is a center for excellence. I fully understand that $300 is a pittance compared to the full cost of the surgery ($25,000) but I curious about it and I am wondering if others have had these hidden costs. Thank you! — Ananta (posted on March 28, 2009)
March 28, 2009
I didn't have to pay anything but my usual doctor office visit co-pay. I
guess it would depend upon your insurance plan. I have BCBS, PPO so the
docs are contracted to provide care for set fees and not "extra".
That said, is perhaps your fee associated with a weight loss program? That
is something that is not normally paid by insurance companies. With my
insurance it would be considered the same as Weight Watchers, Jenny Craig,
or gym fees, etc & those costs are not covered benefits.
— Arkin10
March 28, 2009
Thank you Pat, for your answer. I pay co-pays as well. This is outside of
the contract, which is why it's a bit suspect. It's required of *all*
patients, regardless of their insurance status, and it's definitely not for
the preoperative class or anything diet related like a program. That I
could understand. I could also understand if they were actually doing the
admin work of putting this together for me, but as an HMO patient I have to
go to my PCP and put together all of the pre-op requirements myself (EKG,
chest x-ray, blood work, psychological evaluation etc) and hand deliver it
to them. It says, "All patients will be required to pay an
administrative fee of $300. The fee will be collected on the date of your
preoperative class. Payment must be in the form of cash, cashier's check,
or money order only." I contacted my HMO and they said legally they
are only allowed to accept payment for what is contracted. But in the real
world my insurance only accepts four Doctors in San Diego and I already
have my referral for this one. What choice do I really have? Has anyone
else run across this? Thank you!
— Ananta
March 28, 2009
I paid an "application" fee when I did my first paperwork of
$250.00 and $300.00 for a psychological evaluation and group sessions with
the center's psychologist. They get you coming and going! But it was
worth it:)
Good luck,
Rena RNY 4/30/08 Duke NC
110 lbs; 117 lbs gone forever!!
— RenaMansi
March 28, 2009
Hi Dana, It was interesting to read your profile at this site. I'm a Jewish
gramma to two adorable little ones, the mother of two grown sons and just
celebrated my 32nd wedding anniversary. I'm also a writer and used to own
my own weekly newspaper in No. Calif. Anyway, YES, to answer your question.
I had to pay $300 cash (insurance did NOT pay for this) for a class that
was run by my bariatric surgeon's nurse. I was surprised by this additional
cost, but found it to be very worthwhile. Lots of hand-outs, discussion and
a binder of useful information. I had the lap band done on 8/26/08 and am
down 52 pounds to date, 1/2 way to my goal. I understand your concern about
this fee but it might have something to do with the Circle of Excellence
designation that some bariatric centers have (mine does). Wishing you well
and hoping this helps. jeri
— wildj
March 28, 2009
Yes.. not directly to the surgeon but through the program... I am going to
the University of Penn Hospital.. you have to go to their psych.. that is
$275.00 and then pay $200.00 for the nurtitionist program...
— wendy-s
March 28, 2009
I had to pay an "administration fee" of $350 at my doctor's
office. The fee covered the pre-op class, a small binder of materials I
was given at the class, the psych eval, and the nutritionist eval/meetings.
My doctor's office only took cash and credit cards. I also still had to
pay co-pays to see the surgeon but I did not need to pay co-pays when I
went to see the psych and nutritionist. It made sense to me, because many
insurances don't pay for the psych eval and some don't pay for the
nutritionist meeting, so between those things and the materials, it was
okay.
— ads2e
March 28, 2009
Hi, not only that I have to pay up-front my deductible which I know but i
also have to pay whatever my out-pocket is. so i have to pay a total of
$3750.00 for even having my surgery.
— Teresa B.
March 28, 2009
Sounds to me like you're getting off cheaply! My psych evaluation was
$200, and as soon as the surgery is scheduled I have a second meeting with
the surgeon, at which time I will have to pay $600 to the surgeon, cash or
credit card. He's considered one of the top bariatric surgeons in the
world, so he's totally legit. The reality, I think, is that since I have
insurance, and the insurance company doesn't pay what he would normally
charge, this is his way of making up the difference. . .
— agwc
March 28, 2009
I have also had to pay $375 dollar fee that covered the cost of materials,
education and the psych eval. I also have a $2000 copay for the surgery
and a $500 deductible. So in order for me to get the surgery I had to pay
a total of $2875 and that is not including office visit copays.
— [Deactivated Member]
March 28, 2009
The only thing I had to pay was $90 for the preop program and the psych
eval. If everything is above board, then they should have no problem with
telling you what exactly this if for. Don't hesitate to ask - It is just
smart on your part, unless you just have the money to throw away. They
should be able to tell you exactly what it is for and why you have to pay
it even though you are doing all the work. Then you won't have to wonder
about it and their integrity anymore.
— Dawn A.
March 28, 2009
I will have to pay an administrative fee. I wish mine was a mere $300.00
but mine is $1,000.00. YIKES! but I have plenty of time to save since I
found out I had to do that 6 month weigh-ins and diet. tears....oh well,
better than not having it at all.
— Ambria
March 28, 2009
Thanks everyone! Yes, this is in addition to the psychological eval,
nutritionist, tests, insurance payments etc.... $300 is not my final cost
it is simply the only payment that is vague and that I must pay in cash.
Thanks Dawn, you are absolutely right, asking them to account for it, and
also why "cash only" will truly give me the answer I am looking
for... I honestly was scared to, I guess I just think- here is my chance
and if I question anything it's going to screw it up. Thanks again
everyone... it's amazing how varied it all is coverage or no.
— Ananta
March 29, 2009
I would ask for a detailed explanation of what this fee covers. I had to
pay some out of pocket expenses for nutritional counseling, etc and that
was approximately 600.00 but the nutritionist was and is available to me
anytime I need to ask a question even at 2.5 years out. Good luck with
your surgery!!
— ttambo
March 29, 2009
I had and admin fee as well but it was not cash only. I paid $200 and it
included nutrition, exercise and psych visits for the first year (if
needed). I am one year and two months out and have not utilized any of
these post op visits. I was made aware at my last visit that I needed to
see the nutritionist and that there would be no fee since it was paid up
front. I am sure that the fee they are requiring is for the same reason.
They can not just charge an admin fee without reason. I would definitely
ask what it includes. Unfortunately, even if you don't need it, you still
will have to pay. Hey, at more than 70 lbs lighter...that "fee"
was well worth it to me! LOL Good luck!
— Gods_destiny
March 29, 2009
I would call your insurance company and see if the doctor's office can do
this. If they have contracted rates with the doctor he may not be able to
charge extras. I only paid my co-pays and nothing else, my insurance
company told me I was only responsible for my office visit co-pays and
nothing for the hospital stay. Good luck!
— jeannefitz
March 29, 2009
I had to pay $300 for my program
— lanicole
March 29, 2009
I had to pay $300 for my program at Hahnemann Hospital.
— lanicole
March 29, 2009
The doctor I have met with to discuss a revision requires a $1200
"admin fee", but I was not told "cash only". I would
ask them why they say cash only, and be wary of a doctor who does things
"cash only". He could be requiring cash only so that the money
is not on the books and he doesn't have to pay taxes on it, or it could be
for some other shady reason. Also, if you do pay cash, you MUST get a
receipt so you can claim it as a medical expense on your taxes. If they
refuse to give you a receipt, I would be contacting the medical board and
the hospital this doctor is associated with.
— DoingItAgain
March 30, 2009
Hi...I don't have a surgery date yet, but I've been going to support
groups, behavior mod., nutrional, and fitness meetings at the Center of
Excellence that my surgeon runs. I understand that once I schedule my
surgery, I will be required to pay $1,500 at least 7 days prior to my
surgery date. I, too, questioned this since my insurance covers the
procedure. It was explained that this fee covers all the admin stuff (the
center is working to coordinate EVERYTHING - I don't have to deal with any
of the insurance stuff), as well as lifetime follow up with the surgeon,
lifetime availability for support groups, nutritional counseling, fitness
consulting, etc. without ever paying another penny. At first I was really
leary about why I have to pay this, because I know several others who have
had this and have only had to be pay co-pays for accessory doctor visits,
but when I polled others who have had this surgery by this doctor, they
have assured me it is welllll worth the $1,500. I am hoping to get my
surgery date in early/late May 09.
— GiveMeTheGreenlight
March 30, 2009
Yes i did have to pay $150.00, I felt like it was kind of frustrating too
but they told me that it was for them to gather all the information, for
any classes that i go to preop, blah blah blah. They also would not
schedule my surgery unless the money was paid, so i have paid it and still
waiting for my surgery date!! ugh! anyway, yes i too had to pay an
adminitration fee. best of luck with your new journey! sending hugs and
blessings, Cora
— jnclshrum
March 30, 2009
My office requires an administration fee of $500. I spoke to a friend whos'
office is charging her $6800. I think the majority of offices charge some
type of administration fee.
— deannhuss
April 2, 2009
Do Not pay anything... that's coming from my surgeon.... I first went to a
WLS Dr that wanted 500.00 to start everything... paperwork blah blah
blah... then I went to my surgeon I have now. he told me that I should
never have to pay upfront .. nothing other than a co pay.. would you go to
Heart Dr or lung Dr and if they told you they wanted something more than
just your copay I hope you would walk out... Find out from your ins if you
need a referral to see a specialist WLS is the same a specialist... any of
the guys asking for 100+ as a down payment is not right... I'm glad I never
put down any $$$ and now i have the #1 surgeon in AZ...
— playgirl2077
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