Question:
Surgeon/Insurance question

Hello all! This is my first post here at OH. I've learned so much already! If approved, I am having my surgery done at the Bariatric Center out of Akron City Hospital by Dr. Adrian Dan. So far, I like him a LOT. Has anyone else used this facility or Dr. Dan? What was your experience like? Also, I have MMO and they have a cap of $10,000 for WLS. I will have to self-pay the balance. Any insight to this carrier (approval time, etc.), and can I get some idea of what a RNY costs at this Center. Thanks so much! ~~**Sandy**~~    — BykerGrrl (posted on May 16, 2007)

May 17, 2007
Hi Sandy and thanks for asking your question. If you have seen this surgeon, then they should be giving you a complete estimate of what you are expected to pay. Don't go into this blindly. The price can be straight or funny. Let me explain. My wls surgery cost (the charge on the bill from the hospital), was $30,000 (approx). My insurance coverage paid approximately $10,000, and by contract they had to write off the balance, so I had my co payment which was $11 a day with Tricare and that was it. If the same costs were applied to you, you could owe the other $20,000, or since your insurance paid their portion, the hospital might have to write off their agreed amount with your insurance company and then you pay what is left over. If your hospital has no agreement with your carrier, then you could owe the full difference. Your surgeon and hospital should know but the responsibility is on YOU to find out. Please don't go into this blind. You might be successful with surgery but be shocked at a huge balance. Please visit with them soon. Patricia P.
   — Patricia P

May 17, 2007
And don't forget that the doctor's fee isn't usually included in the hospital charge. The anesthesiologist might also send you a bill. And I had to do a psych consult and nutrition consult which weren't entirely covered. I don't have your insurance, but the previous responder was right -- ask LOTS of questions so you know exactly where you stand. I am in CA so prices are probably quite different, but my hospital bill was $41,000 and my MD was $7000. Fortunately almost all of it was covered by my insurance.
   — promises2keep