Question:
Is there a surgeon who does not require out of pocket $$ 300 plus before I can began
insurance approvals?I've done years of research and now at 30 yrs of age I work for a wonderful company that has BCBS of MN and YES(thk u God) it covers the wls and yet every surgeon office that I contact requires out of pocket money pd b4 first consultation,Is this normal? I'm open for suggestions and because it's so important to me I'll sacrifice and pay whatever... I also need a angel. — [Deactivated Member] (posted on September 24, 2004)
September 23, 2004
I think your last sentence is very interesting.. and the surgeons know most
people feel that way! People are desperate and are willing to pay
whatever.. so they charge them insane fees. If your insurance covers the
doctor's visits, etc.. you will only have to pay the contracted rate. The
only thing I had to pay was $200.. and that was after I was approved and
surgery was scheduled. I also got that $200 back by attending all of my
post op appointments in the last two years. It is a motivator for patients
to stick with their follow up. If I had not have followed up, the money
would have gone into the chaplain's fund at the hospital. Definetly not a
money making scheme. I have heard of offices charging thousands of dollars
just to be seen. I think that is unethical! Search around and look for a
surgeon that is reputable. To me, 300 buck just to be seen for a first
consult.. no way. Good luck!!
— SarahC
September 23, 2004
I don't know if there are any programs that don't charge a fee, but that
seems to be more and more the norm. I know the surgeon I went to almost 2
years ago now charges a $500.00 fee, and they spend a lot of time educating
people before surgery. I work with a woman who had surgery last month, and
she ahd a lovely binder chocked full of information about all the tests and
why to what to eat after surgery and so forth. I sure wish I would have
had something like that! So much of what they do does not get any
reimbursement by insurance companies, so they have to recoup the cost
somewhere. (The employees that do the teaching have to get paid.) Paying a
hefty fee up front also helps to ensure that you get people that are
committed to having surgery and doing what they need to do.
— koogy
September 24, 2004
Up front 'fee' for WHAT? If its upfront fee's 'incase' you insurance
doesnt pay; then NO they cant (If say a PPO) as for money up front. If its
for a 'suport group' fee ex...which Ive heard of some charging then yes, I
guess than can; if people are willing to pay then they can charge... Our
surgeon did NOT charge for an aftercare program.... BEFORE I paid anything
I would find out what it is for first. I have heard of them charging a
'non refundable' charge up front then NOT taking the 'patient' and that
person was out the money for nothing... a big scam... be careful
— star .
September 24, 2004
For me, at Barix Clinics, I had to pay $85 at the time of the first
consultation. With my Capitol BC/BS coverage, I only had to pay the $85
for the consult and $15 for pre-op bloodwork. Everything else was covered.
So, for me, I figure $100 for the entire surgery (consult, ins. approval,
nutritionists, hospital stay, pre & post-op tests & visits) is a
really good deal. Yes, I only paid $100 out of pocket for all of my weight
loss surgery expenses with BC/BS. So, my guess is that it's normal to pay
for the consultation, but you can always write it off as a medical expense
come tax time. Good luck and it will all be worth it. At 22 months post
off I have maintained for over 4 months, my weight loss of 198#, leaving me
at 117#. Good luck!
— klinzey
September 24, 2004
Our program charges $500.00 for a program fee. The services we provide to
all of our patients include. Two full time Bariatric dieticians dedicated
to only our patients and this service is free for life. An education
manual specific to our program and care pathway that can be updated
periodically. Access to a specialized computer program and internet site
similar to obesity help.com. to help track chart and follow any information
about diet ,exercise and patient specific needs. A preoperative fitness
evaluation and consult to plan postoperative exercise. This allows the
surgeons keep track of their patients progress. It also allows us to use
this information to publish research to prove to the insurance companies
that obesity is a disease. I can't say that every surgeon uses the fee for
this purpose but at the University of Cincinnati Center, the surgeons do
not see the fee. All the funds return to the program and ensure that our
patients get the latest and best information and care possible.
Ohio insurance barely covers the actual cost of the surgery and hospital
stay if they even offer the benefit. The amount of the fee depends on the
cost of providing services the insurance company may require before surgery
but refuse to pay for. I have seen some pretty outragous fee amounts. I
would enquire as to specific reasons the surgeon or group requires the fee.
Where is your money going? I hope this helps.
— selwynca
September 24, 2004
Brenda,
The first surgeon I went to DID charge a $500 NONREFUNDABLE fee up front..
so I kept looking. I was not going to pay that fee if I didn't have to. And
I didn't.. I found a wonderful surgeon to do my surgery who charges NO
upfront fees at all. The only thing I paid was my co-pays.. $25 for appts
with the surgeon and $200 for my hospital stay when I had my surgery. My
surgeon (like most) DOES make you see a psychologist for an evaluation and
my insurance wouldn't pay for that because the psychologist was "out
of network" so that cost me $190, but the only other cost was my
co-pays and travel expenses (I live in Salt Lake City and my surgeon is in
Phoenix)..
Keep looking, there ARE surgeons who don't charge these fees. If you don't
mind traveling to Phoenix, I know of a great surgeon down there. Email or
look at my profile for more info. Good Luck!
— Mike F.
September 25, 2004
I was tricked into paying a surgeon 500.00 to help with the high costs of
his medical malpractice insurance. He promised he would be accepted to a
new hospital to perform the surgeries within 2 weeks. This is 5 months
later and he is still accepting this "program fee" by new
patients and still does not have his operateing priveledges. These new
patients are allso promised it will only be a couple of weeks. So when the
patients move on and get there surgery elsewhere, the doctor pockets the
500.oo for seeing the patient one time in his office and is allso
compensated 180.oo from the insurance company. Please make sure the doctor
is currently performing the surgeries before you hand him any money. I am
awaiting my refund and will update when it is refunded and whether or not I
had to take it to small claims court. Which I will and suggest everyone
else with this problem does if we have to.
— Bobbie A.
September 27, 2004
KEEP LOOKING, I am not saying that you will not have some out of pocket
expense, but a fee upfront is strange. If the doctor is in your network I
would ask why he asking for such a high fee. I wanted to go to a local
doctor and they wanted $1300 for the support group. I went to Barix
Clinics and their support group is included with surgery for life. I also
checked out some other area doctors and they wanted a upfront fee of at
least $500 and they said that this is for the support group as well. I
feel like the support group should be included or at least less expensive
for those of us who can not afford it. I on the other had work a really
crazy schedule and would not be able to make any meetings during the week.
When i explained this to them they said I would still have to pay the fee
before getting scheduled for surgery.
— JerseyGirl
October 5, 2004
I do not know of a dr. that doesn't charge an upfront fee. I had to pay my
dr. $175.00 but was refunded all but the $20.00 copay. Most people in my
area are refunded all but their copay.
— juju524
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