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.
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