Is This Right???

[MissyJake 0]

My surgery is, day after tomorrow and I received a call from the Dr's Office today saying they wanted me to pay for my "After Care" and Surgery costs. $2000. 00. That's after my insurance pays out. The "After Care" seems a little ambiguous as I still have to pay my co-payments whenever I go in.

It supposedly covers having access to the Dr. 24/7 and access to the Nutritionist and Nurse at any time , plus the support groups they offer.

I asked about 2 different bills I received in the last 2 weeks from them,( I have called the number listed and have received no return call) She explained that the Dr. is part of the Clinic (Hospital) and they bill seperatly. So my Co-Pay only goes for the Dr. visit.

The clinic charges was $150. If I see my Dr. in the office it's as though I'm going, to the hospital and being charged a facility fee.

I'm so Pissed they bring this all up 2 days before my Surgery.

Any thoughts?

[LadyBug236 0]

My surgery is, day after tomorrow and I received a call from the Dr's Office today saying they wanted me to pay for my "After Care" and Surgery costs. $2000. 00. That's after my insurance pays out. The "After Care" seems a little ambiguous as I still have to pay my co-payments whenever I go in.

It supposedly covers having access to the Dr. 24/7 and access to the Nutritionist and Nurse at any time , plus the support groups they offer.

I asked about 2 different bills I received in the last 2 weeks from them,( I have called the number listed and have received no return call) She explained that the Dr. is part of the Clinic (Hospital) and they bill seperatly. So my Co-Pay only goes for the Dr. visit.

The clinic charges was $150. If I see my Dr. in the office it's as though I'm going, to the hospital and being charged a facility fee.

I'm so Pissed they bring this all up 2 days before my Surgery.

Any thoughts?

Call your insurance company and confirm this is not an "extra clinic charge(s)" that are not covered by insurance but the doctor bills YOU separately.

(number should be on the back of your insurance card)

[MissyJake 0]

BCBS office opens 5am my time and I WILL be on the phone........

Call your insurance company and confirm this is not an "extra clinic charge(s)" that are not covered by insurance but the doctor bills YOU separately.

(number should be on the back of your insurance card)

[honk 780]

A couple years back I read an article where doctors offices were starting to charge for conceirge (sp) services. By this they meant actually getting care from the doctor vs. nurses. Some of these costs were 5,000 and it was not covered by insurance. Many people on here say they have to pay a program fee. It seems like you are paying a cross between a program fee and a conceirge fee. The whole access to the doctor and Nut at any time thing seems dodgey to me. Should'nt you be able to get medical advice from someone even if it's an oncall doctor if yours is on vacation or something? Not sure if you really have a choice at this point but I would personally be irritated about this revelation.

[peacequeen 434]

Oh wow..that's not right. They should've disclosed any out of pocket fees way in advanced. I was informed at the seminar of a program fee of 500.00, split into 2 payments..1 due at the consultation and the other before my surgery date (I don't have a date yet). I was told there would be out of pocket amounts due the day of my consultation that the insurance wouldn't cover. My consult will include labs, psych eval, nutritionist and surgeon..along with any questions for the insurance coordinator. Back in Feb. they mailed me a packet of info that included what I would need to pay before my surgery. I have to pay about 400.00 at my consult. I have a deductible I have to meet, co insurance amt and annual out of pocket that will be billed after the surgery. I would want specifics on what that "after care" includes. It might be for services you don't really need..(say if you have an emergency in the middle of the night, I would probably head to a nearest ER instead of calling my lapband surgeon). I'd ask if any of these fees are optional. You shouldn't have to pay any extra for the regular care that was to be included in the cost of the surgery. Good luck! I hope it all works out..sorry to ramble on but I absolutely hate surprises when it comes to money.lol With the economy the way it is..you have to plan.. You have 2 days, well I think that is insane!

[kloee 1]

My Dr office is 24/7 at no extra cost. Same with nutritianist.

[ElfiePoo 109]

I have 24/7 access to my doctor/nurse/nutritionist and all I have to pay are my co-pays or deductibles. Personally, I would tell the doctor that they can keep their 24/7 service and support groups and you'll just do the office visits for fills/problems which are covered anyway by insurance. Then I'd call the insurance company and let them know what the doctor is doing. Based on their agreement with the insurance company, they may not be allowed to do this.

.

[FLORIDAYS 3,040]

I'm so Pissed they bring this all up 2 days before my Surgery.

Any thoughts?

I am a self pay and my Dr is 24/7 at no extra cost. Same with the hospital dieticitian. I got 3 months of free fills, free support groups forever and 3 free visits with the hospital personal trainer.

However the point is that I knew everything up front. If you didnt... I would calmly speak to the office manager and let her know you were not prepared for this extra cost and work out a payment schedule. I am sure they will be accomidating.

[Jachut 487]

That's kind of the way it works here.

Here, Medicare provides covereage for everyone, whether they're insured or not, for 85% of the scheduled fee for a doctor's visit/service/surgery. Naturally, doctors charge a lot more than the scheduled fee! Private Health Insurance pays for your hospital bed, and depending on the policy, the gap between the scheduled fee and whatever the doctor actually charges.

for my band, and indeed for my bowel resection, oh and to my obstetrician for each of my babiesn, the surgeons charged a one off out of pocket charge, not covered by Medicare or Health Insurance. For the band it was $3,000. What that means is that forever after, my doctors visits, fills and any revision surgery are charged only at the scheduled fee and are billed directly to Medicare. so there will never be another charge that I have to physically pay;. For lapbands, it certainly encourages commitment to attend follow up appointmens and fills.

But to charge that and THEN to charge you copayments as well - greedy!

[Phranp 46]

Temecula,

I live in L.A. and I am insured by BCBS, and what you are being asked to pay sounds VERY wrong. Admittedly, I had to go from doc to doc to find one that would accept BCBS for lapband because BCBS does not pay them well -- not at all. But, once I found a surgeon I did not pay one penny for my hospital stay and (once my doc moved into his Beverly Hills offices) he no longer accepted my co-pay when I saw him for fills. (Personally I think something shady was going on in his previous office, especially since they only took cash.)

If the money they are asking you to pay is not a problem for you and you don't want to postpone, by all means, do it. BUT, I would call not only BCBS, but also the benefits dept at my job to be sure that what they are doing is legal, ethical and necessary. There are so many programs for lapband and it's true, some are more expensive than others. But know this, not all of them charge the "extra" fees your doc is charging and, like others have said, some of that stuff you don't need (i.e., his specific "support group" -- there are all kinds of free support groups around).

Good luck to you! I certainly understand that you don't want to postpone at this point.

~Fran

[54Shirley 105]

It sounds to me like the ins. co. is trying to get you, to back off threw the Dr...

I would be on the phone tomorrow, on the internet tonight, and looking at your policy to see if Bariatric surgery, fills are covered. Support Groups are usually in your area somewhere.

Dietitian info you can get from people on here too.

Where I went, as soon as you had surgery,,, the Dietitian was yours to use for life ! No matter what kind of INS. you had, as long as you had surgery, even self pay! So I can't understand this whole thing, really. Look it up under your plan, and log in, and see what it tells you about additional payments when it comes to this surgery. I wouldn't pay it. If it is the Dr... go someplace else, or go for surgery, and fills, even a fill center makes more since then this.

[Jack 855]

something is certainly creating a bad odor here, and for sure I would check it out completely BEFORE any surgery is completed. This is not a normal practice in my area.

[oceangirl6 0]

i had to pay 4000.00 out of pocket for aftercare too

but i have known about it from the get go

my doc says no insurance co. will pay for his aftrercare requirements

i am still going to try and get some of my 4 grand reimbursed

but its up to me to do it

good luck

My surgery is, day after tomorrow and I received a call from the Dr's Office today saying they wanted me to pay for my "After Care" and Surgery costs. $2000. 00. That's after my insurance pays out. The "After Care" seems a little ambiguous as I still have to pay my co-payments whenever I go in.

It supposedly covers having access to the Dr. 24/7 and access to the Nutritionist and Nurse at any time , plus the support groups they offer.

I asked about 2 different bills I received in the last 2 weeks from them,( I have called the number listed and have received no return call) She explained that the Dr. is part of the Clinic (Hospital) and they bill seperatly. So my Co-Pay only goes for the Dr. visit.

The clinic charges was $150. If I see my Dr. in the office it's as though I'm going, to the hospital and being charged a facility fee.

I'm so Pissed they bring this all up 2 days before my Surgery.

Any thoughts?

[Apples2 19]

I agree...something smells with the "added" fees. I have BCBS and the one and only "fee" I have had is my annual deductible. Nothing up front...no added fees to be paid to clinic or LB doc. I certainly would not feel comfortable being left with paying for some cooked up fees some doctor/clinic calls follow-up charges.

[JourneyGirl 10]

I agree with Jack. I know how much you want the surgery but something seems really wrong here. Until you find out just what is going on and just what they expect as far as payment from you I wouldn't let them touch me.

I am seeing, through this thread, just how blessed I am. My insurance requires no co-pays, no deductibles, no out of pocket costs what so ever. My doctor (and his practice) have been so up front. We have access to them 24/7 and get to have the nutrition class, exercise class and as many support group meetings as we want at NO CHARGE!

Check into this guy and his practice. Something isn't right. Good luck!!