Oband Centers - Out of Network?? does this sound fishy?

synthangel
on 9/22/16 10:35 am, edited 7/27/12 5:35 am - NV
VSG on 11/02/12

Ok few things here, first did anyone have there surgery at Oband centers? 

Also if so was it 'out of network' for your insurance?

I have Aetna POS choice 2 and I was going to go to Dr. Atkinson (sp?) here in Las Vegas cause he is in network for my insurance. So I called their office and they referred me to the Oband center because they were have some 'contractual issues' so I went to the oband center for the orientation/seminar which is required by my surgeon and they told me....

That all of Dr. Atkinsons patients will go there for their post op stuff (3/6 month diet, NUT, psyc eval, ect) and that if I wanted I could use Dr. Atkinson still and that all my paperwork would get transferred to that office at the end of the pre op....

OR

If I want I can use their in house surgeon Dr. Sergey Lyass (anyone use him?) and if I did do that then I would only have to do 3 months for sure an that I would not have to pay anything out of pocket???

Does that sound legit?

The cooridinator explained it me like they have no cap on the billing because they are out of network so they will bill the insurance company however much and the insurance company will send ME a check and then I take them the check and sign it over??

Anyhow I don't know if this sound right, any info on this would be greatly appreciated :)

Lisa S.
on 7/27/12 5:36 am - NV
VSG on 07/09/12
First of all...any provider that is out of network will bill you whatever the insurance does not pay. So even if the insurance sends you a check, chances are you will still have a balance. And "no cap" on billing means they do not have a contracted amount with the insurance company, they can bill whatever they want. In other words, if they are in network, they may bill $5000, the insurance pays $3500, the balance is written off. Out of network, they bill $8000, insurance pays $2500, you are responsible for the remaining balance. In my opinion, I would NEVER use an out of network provider. Do some checking around, there are other docs in Vegas.

    


 


synthangel
on 7/27/12 5:43 am, edited 7/27/12 7:44 am - NV
VSG on 11/02/12
 So I just called back dr. atkinsons office and they said that was not right. They dont know how I got transferred to the oband center (it was through their answering service so maybe there was  a mistake?) They also said that Dr. Atkinson does all of their pre op in house so now I have ANOTHER seminar to go to tomorrow...

Is this some kind of a scam or what? Becareful out there people .....
synthangel
on 7/27/12 5:45 am - NV
VSG on 11/02/12
 Thanks for your reply Lisa!

Seriously sounded weird and I didn't feel comfortable with the process they were explaining. This is so weird. I am curious to know if anyone else has ran into this?
Wiasbeck
on 7/27/12 5:51 am - NV
I'm in Vegas too and I used Dr Umbach at Blossom Bariatrics. I loved my experance there if you are still looking around.
Pre-op -7.8, M1 -21.4, M2 -18.4, M3 -?
          
m      
synthangel
on 7/27/12 5:53 am - NV
VSG on 11/02/12
On July 27, 2012 at 12:51 PM Pacific Time, Wiasbeck wrote:
I'm in Vegas too and I used Dr Umbach at Blossom Bariatrics. I loved my experance there if you are still looking around.
 I would love to use Dr. Umbach he is actually listed as my surgeon on this site right now because I was originally going to go to him... but he is not in network and it would have cost a lot more for me to use him. Though I would have loved to. I have a friend who used Dr. Atkinson who is covered so thats why I decided to go with him...

I still can't believe my call was transferred to the wrong company??? 

*venting* I just wasted like 4 hours of my day driving over there just to find out its not even the place I should have gone :(
Wiasbeck
on 7/27/12 5:57 am - NV
 Sorry you can't use him. I'm even more sorry you had to do all that run around. I'd vent too.
Pre-op -7.8, M1 -21.4, M2 -18.4, M3 -?
          
m      
synthangel
on 7/27/12 5:58 am - NV
VSG on 11/02/12
 I'm just so grateful for this site really. I thought something was up... glad I was able to come here to get info and to vent ;)
(deactivated member)
on 5/12/15 4:14 pm

I have an appt with Dr. Umbach now, after all that running around with  O band. They are scamming ppl.

Lizmo_8175
on 9/22/16 8:54 am
Lap Band on 11/30/16

I had the surgery November 2012, done by Dr.Lyass I originally wanted the sleeve procedure because they told me that my insurance would cover the surgery in preparation I was very excited however about a month later after going trough the whole process they inform me that my insurance would not be covering the surgery and my only option would be to either pay $17,000 cash for the sleeve or pay 9000 for the lap band  and putting 3000 down and making hundred dollar payments a month with no interest or credit check. Because I didn't have the greatest credit at the time and I was in a vulnerable state and upset I thought this was my only option so unfortunately I did not research other places I thought this was my only option so I went with the Lap-Band procedure. About a year or two later somehow I was looking through my summaries from my insurance and found that the surgery center at billed my insurance over $40,000 worth of charges. They the oband center/ surgery center stated that they had to do a hernia repair and that's what the charges were for although they never told me that they had to fix a hernia nor was there ever any follow-up care for a hernia repair. Still making payments on my lap band and very unsatisfied with it. I do believe that they committed insurance fraud by claiming this Phantom surgery that never happened however when I brought it to my insurance attention as well as the surgery center they have a photo in my file showing that they did do the surgery although I don't believe it is a surgery that was performed on me but how do I go about proving now that it's been a few years down the road it may be too late. I also had a friend contact The Oband Center that I work with and she has exact same insurance as I do and they had her all hyped up just like they did me stating that our insurance covered it  and I told her that it did not that she better call them back and double-check and talk to insurance company as well sure enough they did the exact same thing to her as it did to me but she caught it before it was too late. I am interested in going to Blossom bariatric and having the sleeve there as my friend has had great success. 

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