PROGRAM FEE?! You're kidding, right?

k_podski · 10-08-2007, 09:47 PM

AGGHH!! I am very frustrated with the hospital that is doing my surgery. They so kindly sent me paperwork explaining that they charge a $500 non-refundable "program fee" to help cover the cost of materials and pamphlets before the surgery can be done.... I would think they could somehow include the $500 fee in with their $16,000-$22,000 surgery... Like the hospital can't afford pamphlets and materials?? Or... maybe afford to charge it in with the insurance? I already have to pay a minimum of 10% of the surgery out of pocket. (Plus I pay $120 a week to have the insurance on myself.) I just don't understand? Has anyone else had to pay a "program fee"?? I am very irritated with this. whewwwwww.... thanks for letting me vent lol....
~Kerri

Michee · 10-08-2007, 10:29 PM

I paid a $200 consult fee, then when I booked the surgery it was deducted from my $16,000 fee

Ailie · 10-09-2007, 06:24 AM

I have a $750 out-of-pocket fee that has to be paid before beginning my program.

MissDarlene · 10-09-2007, 07:43 AM

I changed doctors because the first one I went to required a $1000.00 program fee not billable to insurance. The surgeon that performed my lap-band® didn't require a program fee.

I also called my insurance company and explained why I was changing doctors, and they said they didn't blame me it was rediculous for them to charge something not billable to insurance.

catzintj · 10-09-2007, 07:45 AM

just another reason i went to mexico. one low price and great service. no bs.............

kimmie11 · 10-09-2007, 10:18 AM

Hello, I am new to all this. I have been to a seminar and know my insurance will not pay so I am now looking into a loan. Catzintj can you tell me about your experience with mexico?
Thank you
Kim

faithmd · 10-09-2007, 10:34 AM

Quote:

Originally Posted by MissDarlene

I changed doctors because the first one I went to required a $1000.00 program fee not billable to insurance. The surgeon that performed my lap-band® didn't require a program fee.

I also called my insurance company and explained why I was changing doctors, and they said they didn't blame me it was rediculous for them to charge something not billable to insurance.

I did the same thing, I did not choose two surgeons because they both charged a "program fee" or a "mandatory support group fee."

And 16,000-22,000 is a LOT for private pay for a surgery. I know many folks pay it, but nowadays you can find a quality surgeon that will charge a lot less.

BTW, if you are having insurance pay, but have a 10% co-pay, please confirm with the hospital billing office and the surgeon's office what the total bill will come to. If your surgeon's office offers self-pay at say $17,000, but you are insurance pay, I can GUARANTEE that what your surgeon bills the insurance is NOT 17,000. It is MUCH more than that. So beware basing your figures for your 10% co-pay on the private pay price. Very important to find this all out ahead of time before you get your hopes up and a date set.

IndioGirl55 · 10-09-2007, 10:55 AM

My Doc had/has a LARGE program fee - I will never receive a bill from him for 5 yrs - this coveres all my fills, appointment, pre op diet, I have his cell # access to his nurtionist... I think he got $1500 from insurance period. I know that this is his way around the insurance companies - but I wanted a local doctor with experience - If i need emergency care i am going to get it - i don't have to worry if another doctor is going to accept me as a patient and most of all - I am blessed to be able to have the funds to pay. I figures it was money well spent for my health and peace of mind.

There are general MD's in my area who are doing this - you pay them $7000 annually and you have free access to them 24/7 all your appointments etc - the medical system is such that they don't want to hassell with insurance - My hospital bill was $64,000 for 2 days - insurance paid $3500 - tells you how screwed up our system is..

Shalee04 · 10-09-2007, 12:51 PM

My surgeon charges $3500.00 up front from me , then turns around and bills out of network to the insurance and they hopefully send me something back, they say they pay 60% out of network billed.... Surgeon says if he bills in network he only ends up getting 700 back from them.......

Kelly

jessiel55 · 10-09-2007, 03:23 PM

Quote:

Originally Posted by kimmie11

Hello, I am new to all this. I have been to a seminar and know my insurance will not pay so I am now looking into a loan. Catzintj can you tell me about your experience with mexico?
Thank you
Kim

Also looking in to surgery in Mexico, so far I've called 3 different clinics and so far only one has returned my call the clinic is in Tijuana and their qualifications sounds very good , so I'll be waiting for the others to call back and see what they offer.:ranger:

wnt2lose · 10-09-2007, 03:32 PM

I feel your pain, and this has been the biggest obstacle for me. In addition to our Dr, we have to attend a mandatory weight loss program. This is different from my Dr, and they only bill the insurance co. after I have had the services.

Get this, I had to pay $600 for the initial half-day consult with Nutritionist, Physical Therapist, and Bariatric Nurse. Then we must go to 4 support meetings before surgery in addition to 8 after. Before my surgery I have to come up with another $600 (1,200 total) for the remainder of services. I will meet with the team other times to plan out my course. I may need to have to put the last $600 on a credit card or borrow more money. Plus, I don't even know yet if my insurance company will pay for the program. This has caused numerous fights/arguments between my dh and myself.

Not only that, but until last week, I only met people who are getting the RNY and the leader has also had the bypass, so I felt a little left out.

Part of me is worrying about paying the price, but I would rather pay for this, than fork out money for more Weight Watchers, LA Weight Loss, etc.

Almost forgot, I have to pay the Dr. $300 for costs not covered by insurance.

TNNurse Linda · 10-09-2007, 04:28 PM

Hello,
Will u please tell me how to get my ticker on here ? I went to the site and made my ticker, but cant find a way to get it on here. Thanks

AmberWaves · 10-09-2007, 04:38 PM

My Doctor has a program fee too of $400. Just when I thought I was going to get out of this not paying anything out of pocket besides copays, I get hit with that. It sucks but I guess it's better than having to pay for it all out of pocket, I definately wouldn't be able to do that.

Here's what my Program fee with pay for:

Nutritional follow-up
Tanita body Composition Analysis
Therapeutic group interaction
After Care and on-going Educational opportunites

It also registers me, reserves my surgery date and guarantees a number of post surgical services.

I don't have to have it until my pre-op appointment which is good too. I'm not even planning on having my surgery until January of 08.

TracyinKS · 10-09-2007, 04:51 PM

When I first started calling around.. One place wanted $750 as a processing fee if I didn't end up going with them... they told me on the phone that they accepted insurance, but in reality they would have me pay UPFRONT first and then try to get reimbursed from insurance........... (I CANCELED THAT APPOINTMENT!)

I knew the band was covered on my insurance so I called a few more IN network docs and found one I liked...

I had to attend the seminar FREE
1st consult $150 that was taken off my bill later.

anonemouse · 10-09-2007, 05:26 PM

Quote:

Originally Posted by faithmd

I did the same thing, I did not choose two surgeons because they both charged a "program fee" or a "mandatory support group fee."

And 16,000-22,000 is a LOT for private pay for a surgery. I know many folks pay it, but nowadays you can find a quality surgeon that will charge a lot less.

BTW, if you are having insurance pay, but have a 10% co-pay, please confirm with the hospital billing office and the surgeon's office what the total bill will come to. If your surgeon's office offers self-pay at say $17,000, but you are insurance pay, I can GUARANTEE that what your surgeon bills the insurance is NOT 17,000. It is MUCH more than that. So beware basing your figures for your 10% co-pay on the private pay price. Very important to find this all out ahead of time before you get your hopes up and a date set.

Very good advice. My surgeon charges $18,000 to people doing self-pay, but the bill they sent my insurance was just under $50,000 for just over 24 hours in the hospital.