Question:
Anyone with BCBS of MICHIGAN pay for everything?

My doctor requires $7000 for his fee because he states BCBS doesn't pay enough. Interested to know if anyone has a doctor here in Mich. that took the insurance payment. I need to have a revision from a VBG to an RNY. I want this surgery desperately but really cannot afford $7000. Any feed back would be much appreciated. Thanks to all. I love this site.!    — Kathy B. (posted on October 24, 2002)

October 24, 2002
I too have BCBS and my insurance paid everything except my deductable which was I think $250. Not a bad deal if you ask me. I went to BTC(bariatric treatment center) in Ypsilanti and my doctord name is Dr. Batay-Csorba. He is great and did a wonderful job. I have had zero complications. Good Luck! 7/5/02 Open RNY, -61 lbs.
   — DRutherford

October 24, 2002
I have bc/bs pos of mi. I went to the Hurley Center in Flint. I had to pay 78 bucks.(much better than 7 grand!) But I wasnt happy with the NOT calling back when I came home with staph and had to b readmitted to a local hospital. I am however VERY happy with my surgery. I am 5 months out and down 100 pounds! :0)
   — Sassy M.

October 24, 2002
Hi I also have BC/BS PPO of rodchester,NY because thats what my moms insurance company from her work goes through. but we live in MI. And they told us it was just from a differnt state and they all are the same. I also am going to BTC of Ypsilanti. And just have been approved with no problem they are paying for everything. But about $300 bucks because they are out of network. Sounds like chunck change to 7 grand or the whole surgery cost. To me it sounds like hes only there for the money. Sorry if that sound bad but thats just how it is coming off to me. I never heard of this before from any one else I have talked to. I would find another doct to be honest. If you don't mind me asking where exactly are you haveing your surgery at in Michigan? You can email me personally if you would like at [email protected] Hope this helped a little or something. Wishing you the best luck
   — Starla W.

October 24, 2002
I had surgery last April with Dr. Poplawski. I have BC/BS of Michigan and it paid for everything except for about 56.00...I would really check into what your insurance company says they'll pay...
   — Linda {Kati} W.

October 24, 2002
I had mine done through BTC in Holland MI. What your Dr is doing is having you pay the difference in what he "attempts to Collect" and What BCBS's "approved amount" is, which is what he would only get if he only took what they gave. Bieng that these Dr's choose which insurnces they will and will not perticipate with, if he accepts BCBS than he is well aware of what is going to be reimbursed. Because they are in it for the financial gains of course if he can charge you the difference up front than he makes more money. My suggestion is that you go with a different surgeon, he could be the best in the world but unless you have 7 grand to just give then guess it doesn't matter but most people don't and there are places like BTC that provide this operation without trying to collect what they would really like to get ahead of what bcbs is approving.
   — Rebecca B.

October 25, 2002
In 5/00, I paid my surgeon an extra $4500 to cover "program fees". This covered the cost of the support group for two years and all follow up visits for two years that BCBS would not pay for. I considered it a trivial amount for what I was getting and would do it again in an instant. BCBS-PPO has paid for everything else. Good Luck to you!
   — merri B.

October 25, 2002
The key to who pays what is to determine whether the provider (your surgeon) is a BCBS provider. If he is, he is contractually obligated to accept whatever they pay as payment in full. Chances are, he's not. I have a similar situation. There are three surgeons in my area who are well known for bariatric surgery. All three have gone off BCBS because they didn't like the amount it paid. I will end up paying my surgeon $3500 of my own money in addition to what BCBS pays him. I'm using him because he comes highly recommended and has an excellent reputation. But I'm not happy about what I have to pay out of pocket; I had to borrow the money. Like some of the previous posters, I suggest you try to find a surgeon who is a BCBS PROVIDER. Remember, there is a difference between them accepting a payment from BCBS and being a BCBS provider. Good luck.
   — Arlene S.