Program Fees

I went to a new patient seminar last night, to listen to a doctor I had heard allot of good things about. When we got there we all signed in and were handed information based on what kind of insurance we each had. The first page dealt with my insurance carrier, which I already knew that I wouldn't have any problems with the Insurance company already approved me.

The second page however,  was all about what a unique program they had, and because of the meetings, and on-line, and in office services they provided there was a $ 2,995.00 program fee for each new patient due in cash, or check, at the time you are scheduled for surgery. They pointed out that this was the patients responsibility, and would not be billable to insurance in anyway.

Has Anyone else run across this kind of fee, from a doctor or clinic, this is beyond lab tests or co-pays.

Let me Know
Doc

Welcome Doc to the Ca board.  I did not have any program fees.  But I have read where other people have had the fees.  Every surgeon is diffenent.  Hopefully you will get some input from other people. 

I did get charged 600 bucks, and for what I have no idea.  There are lots of doctors around, go to several, you may find one that does take your insurance and doesn't have this fee.  What I think the doc is doing, is when you have insurance, there is a reasonable and customary fee that the insurance company will pay.  Say his bill is 12,000 bucks, he has signed with the insurance company saying he will accept what the insurance will pay them, which may be 5-8 thousand.  He is just trying to make up the money that the insurance doesn't pay.  Make sense?  Like I said, try other doctors, not everyone is charged.

Welcome to the California Board and keep us informed as to what is happening.

Good luck, Diane

Yeah Diane,

That Is what I was thinking especially since it was attached the information about my particular insurance carrier.

Thanks

Doc

Hi Doc,

I did medical billing for years.  If your Doctor is Contracted then they cannot charge you the difference.  However, if he is "out of network" then he can charge you. Check with your insurance company.


Linda

Pretty common practice. 
Liz

Hi Doc,

First, welcome to the Cali board and good luck on having WLS.

I had to pay a $1,200 fee and that is to cover the cost of monthly support group meetings and calls to the Nut for the rest of my life. But I tell you, I would have paid $2,995 for my doctor if he required it.

Also, I believe Diane is absolutely correct.

Good luck on your jorney....Michele

I had to pay $300 which was for mandatory monthly exercise classes, and I suppose for support groups.  I also had to pay my nut out-of-pocket . . . but all in all . . . my fee wasn't bad.

Chris

My surgeon has a fee but, as a self-pay, it was irrelevant to me. I was okay with the self-pay price and what it included.

It did include 2 years of aftercare and that means I can use their nutritionist as much as I want for two years, make appointments with the in-house counselor as often as I need to, have as many follow-up visits as I need, etc. We also get the support groups, which are run by the surgeons, a monthly newsletter, and some other stuff. The newsletter is actually pretty good and worth getting.

In terms of these services, my insurance might pay for me to see a nutritionist if I had some specific problem, but they aren't going to let me see one just because and it may not be one who is familiar with bariatrics. Similarly we have an EAP at work and I can see a counselor 5x for a problem without question. But if I need to see them more than 5x, then it has to be approved and I'm limited to their stable of counselors.

The way I look at it is that someone has to pay for all the support people they have on staff and that these services contribute to their success rate (which is better than average). The self-pays are paying for them with their fees and the people with insurance are paying for them with the program fee.

OTOH, if you can find a surgeon in your area who has the same success rate and complication rate and doesn't charge a fee, more power to you...

Well it is Ironic, that after my seminar with the doctor I was talking about above I went looking for a another Doc, and I happen to pick your doctor Mac Madame. In fact I have an appointment with in Sacramento on the 19Th. I picked him because he is suppose be one of the best at LAP-DS.

By The Way, Can I ask how much your fees were ?

Doc