Did anyone else have to pay a program fee above and beyond insurance coverage? Mine was $3000.00, just wondering if unusual or not. Is there a way to get reimbursed from insurance for the fee?

Yes, but mine was only $300. $3,000 seems awfully high!

Do you have a flexible spending account? It may be reimbursable through that.

Most program fees are not, from what I understand, reimbursable through most health insurance plans.

Mine was $375. $3000 does seem quite high. What does that cover for you?

No program fee that I know of.

mine was $200. and i agree that $3000 does seem awful high. i'd definitely wanna know what my 3 grand was paying for!

That is how the doc gets more money than what he is contracted with the insurance company for.

I know when I had my surgery the bill was $42k total, but insurance paid the contracted rate of $12k total. So they were out $30k.

Personally if the surgeon tried to this, I would have found another surgeon, they contract with the insurance companies at a set rate, that is what they have agreed to accept for the surgery, I can't believe that the insurance company will go along with this program fee issue.

My program fee was $1000. I filed it on my insurance and part was reimbursed and part was applied to my coinsurance.

My Doc wasn't in my network but took what the insurance paid. No out of pocket to him at all. I did however still need to meet $675 of my deductible for the hospital. he had nothing to do with that. That was from the hospital itself. Still not bad for a procedure that would have been $25,800 total.

The first clinic I went to wanted a $1200 fee paid before they would even schedule surgery (included 16 classes) plus $500 up front before surgery. They would only take cash or credit card. No personal checks. I finally got feed up with them after paying for some of the classes that a nurse taught -while reading off a piece of paper. Needless to say I felt it was a racket and was all about the $$$$$$$. Then they started pushing you to buy the vitamins they sell.(When at seminar - children's chewables were good enough) I finally got online and did some more searching - I found a clinic with no up front cost and felt they were really concerned about me and my health. I have to travel an hour and a half from my home, but it was worth it. I would suggest to keep looking.

Mine was $200 dollars which covered the cost of support meetings and things and i didn't mind paying because i knew that is wasn't for profit it was to help us stay on track. $3000 even though your insurance is coving the surgery should be considered fraud. I would never pay $3000. Your insurance is paying for your surgery, your doctors appointments, your fills. I would see another doctor. This doctor is just out to make money. What does this $3000 dollars cover?

Edited March 17, 201016 yr by reneek

to me any more than 0$ is a rip off. Just a profit center for them. My Doctor did not charge one.

I did not have a program fee at all. I think it should be included in the total cost.

There is a doctor here in Melbourne, Florida that charges a $3700 "program fee" upfront. Needless to say I went with a different surgeon,and there was no program fee and I am so happy I did. I go in for my first fill today! :scared2:

That is really high for a program fee. I was self-pay and I paid a $500 program fee but that included my surgery consultation, psych eval. and meeting with nutritionalist as well as a binder of info. and support groups.

I went through Ellis (Albany, NY) - No program fee, but what they billed to my insurance carrier was incredible - $860 for the same lab work for which my regular doc charges $200.

I have my own nutritionist, but had to see their's - $380 for a recent college grad who read an post-op diet to me..

I agree with everyone who feels it's just another way to pad their costs. Check with your insurance carrier - sometimes by virtue of being insured by a particular carrier these little extras can be waived - esp with some help from your carrier.