Question:
Do you have to pay insurance co-pay or % up front..?

Or if ST Marks has some kind of paymant plan...? my insurance pays 80%...so I'am left to pay 20% plus what....the doctor 20% to....dont get me wrong iam very greatful...that my insurance approved me..but still 4,000-5,000 is hard to come up with....so if anyone knows plz e-mail me @ [email protected] Thanks..:-))    — Adrena A. (posted on June 17, 2001)

June 17, 2001
Depends on your doc. The surgeon I would like to have it be want it all up front $7800. I have had another consult and he didn't want any up-front. I will probably be changing docs.
   — Cynthia E.

June 18, 2001
Whether you have to pay up front or not probably depends upon your insurance and the contract the insurance company has with the doctor. I would think that you would pay your 20% after the fact. Twenty percent of the reasonable and customary charges can be quite different than 20% of the surgeon's "retail" fee. Also, many insurance contracts prohibit the doctor/hospital from collecting any charges for services that would not cover. When I had surgery 8 years ago (not WLS), about 40% of the charges from the doctors, hospitals etc. were written off because they were higher than what the insurance company had contracted for with the various parties. I only had to pay 20% of the contracted rate. And then, only to the stop loss limit of the policy. My stop loss was $1500. The insurance then paid 100% above that. You may have a stop loss limit that would cap what you have to pay.
   — Gina E.