UHC and fills

[Sultana 0]

I am only 2 weeks post-op. I was wondering about the cost of fills. Is it usual for the Dr. to include a certain number of fills with the surgery cost? If so (or if not), how much do the fills run, and does anyone know if UHC covers them? Thanks.

[Alexandra 55]

Hi Sultana,

I think the usual routine is for a certain number of fills (two or three within the first year, for example) to be part of the surgical precertification. This is because the implanted device REQUIRES adjustments in order to be effective, so said adjustments are a REQUIRED part of the surgical treatment.

That said, banding is so new that the codes haven't caught up with the procedures and many carriers are handling fills in different ways. There might have to be clarification from your doctor, a resubmission of the claim once or twice, or whatever, but the bottom line should be that fills are part and parcel of the surgical treatment that was approved. Therefore, they should be covered as part of the original treatment approval.

As far as how much they cost, that varies considerably according to how they're done. I was told that my fill--done by the surgeon himself, at a hospital, under fluoroscopy--would cost $450 out of my pocket *just for the hospital costs* if my insurance didn't pay (which it did). But that's pretty much the the most expensive way to have a fill done, so that's got to be at the high end of the scale.

[Sultana 0]

Hi Alexandra,

Like I have said before, you are a wealth of information! I am hoping that because I am with UHC that they will cover the fills. I know that I am perhaps borrowing trouble, but I am a "look forward" kind of person and already I am worrying about my first fill and I am only 2 weeks post-op! It seems that some people breezed through, and others had difficulties. I do have a highly skilled and qualified Dr. (Kurian), so I am hoping I will be part of the first group. I wonder, does there come a time when band living becomes just a part of life that you become so accustomed to that you no longer have to fret or anticipate snags? I sure hope so!

Again, thanks! Have you noticed that I am finally getting the hang of putting my posts in the correct place!!!

[Alexandra 55]

I wonder, does there come a time when band living becomes just a part of life that you become so accustomed to that you no longer have to fret or anticipate snags? I sure hope so!

I think yes, indeed, there does. Two weeks post-op is not it, though! You're forgiven your worrying; it's perfectly understandable.

Dr. Kurian is absolutely at the head of the class as far as followup care goes; I don't think you have anything at all to worry about.

[Graceful One 4]

Sultana,

I just got my EOB for my first fill done in office without fluro and it was $300.