Ok, I just got the revision packet from the surgeon's office I have been considering for my revision surgery. Overall, the packet is pretty standard, asks all the standard stuff for your background- but on the first page it states that there is a non-refundable $500 fee to cover costs NOT COVERED by insurance. They say it is to pay for them to submit the insurance approval, post-op (support group) and misc. fees.

I'm sorry, but even though this Dr. is FACS, ASMBS and I have check his state licensing board (no negative remarks), and has lots of people who have talked well of him. I don't know if this is a new fee to recoup costs that he doesn't get from the negotiated rates from the ins. companies, but it doesn't sit well with me.

Anyone ever heard of this?

I had a $500 non-refundable fee, but it was applied to my final payment (if insurance had covered it, it would have been part of my copay). Or, if I had cancelled the surgery after reserving my surgical date, they would keep the money.

I thought that was fair.

Are you sure you are understanding the upfront fee correctly?

I had a $500 non-refundable fee, but it was applied to my final payment (if insurance had covered it, it would have been part of my copay). Or, if I had cancelled the surgery after reserving my surgical date, they would keep the money.

I thought that was fair.

Are you sure you are understanding the upfront fee correctly?

I don't know, but it does say that it is required at the first consult visit- period. So, I could pay that $ and then not like the surgeon and pay $500 for a 15 min consult? I don't think so.

I will verify with their office but their letter seems pretty clear.

That does seem crazy!!!!! Definitely verify ... if they work like that, it's probably a good sign to find another surgeon.

That does seem crazy!!!!! Definitely verify ... if they work like that, it's probably a good sign to find another surgeon.

Yeah we will see. Just wanting to see what others thought. I do have a $700 yearly maximum out of pocket and I expect to pay that towards the surgery, but to me if they are contracted with an insurance company for their services I didn't think they were allowed to charge additional fees. That's the whole point of the negotiated rates. Going to verify with the surgeon's office, but also call my ins. company too. I expected to pay my $30 co-pay for the consult, but that's it until I made the decision to move forward.

My doctor also asked for the same thing. They say it's for the "free" seminar, the support groups, etc. I think it's basically just to try to make up some difference because of what insurance will actually pay them (just an opinion though). I think too it helps weed out some people who aren't really serious and the doctors staff can spend hours working on filing with their insurance and misc. paperwork so that kind of would help insure that they are serious about having the surgery. I was a little leary of the fact that they were asking for the money but out of all the research I did on the doctor I couldn't find anything negative said about him. It was also kind of a motivator for me cause sometimes when I would start freaking out about my decision to do the surgery I would stick with it cause I had already paid my money.

I had a $600 non refundable fee. I think, personally, it is reasonable. But, I was a self-pay patient and think every cent I paid was worth it.

I was self-pay and didn't have any kind of "program fee", but I see a lot of people asking/complaining about them (rightly so), and I think they're a big load of crap... just a way to bring in some extra money.

My doctor required $205 upfront for his first visit. But this is being applid to coinsurance after insurance pays. I first freaked about it as I had to wait until I had the cash but once I started there was not turning back. I really wanted this surgery adn I do not regret this at all. I have monthly support groups. The insurance scheduler was great in making sure I had all my paperwork and also responded to my numerous emails. Today I sent email to the bariatric nurse and she responded within 30 minutes. My support staff is great with my doctor and I have no regrets whatsoever. I was very confident with this office as I had an old supervisor who had her bypass done with him.

My doctor also asked for the same thing. They say it's for the "free" seminar, the support groups, etc. I think it's basically just to try to make up some difference because of what insurance will actually pay them (just an opinion though). I think too it helps weed out some people who aren't really serious and the doctors staff can spend hours working on filing with their insurance and misc. paperwork so that kind of would help insure that they are serious about having the surgery. I was a little leary of the fact that they were asking for the money but out of all the research I did on the doctor I couldn't find anything negative said about him. It was also kind of a motivator for me cause sometimes when I would start freaking out about my decision to do the surgery I would stick with it cause I had already paid my money.

Well, mine is a revision and so I know what this is all about. I understand what you are saying, but I'm sorry I don't think its reasonable. What's next?

Dr. offices have a set amount of appointments for consults, and surgery time. It just seems unethical to try and bypass the insurance company charges. I still am having a difficult time with the fact that they sign contracts with the insurance companies with their various charges- period. End of Story.

Yeah I know, if I don't like it- find another surgeon. I'm just disappointed because he was checking out so far...

I think most programs have a fee in place for administrative, educational and support costs. All of the intangibles that make the overhead for a bariatric clinic higher than that of a general surgery practice.

My guess it is there way of weeding through those who are serious. Can you imagine the hours put into the insurance calls, talking to pts and all the paperwork? I wonder what the actual percentage is of those who start the process and then walk away???

do u happen to be in the kansas city area? just everything you described sounds like what i was told although i'm sure there are a lot that are the same. anyway just curious.

My guess it is there way of weeding through those who are serious. Can you imagine the hours put into the insurance calls, talking to pts and all the paperwork? I wonder what the actual percentage is of those who start the process and then walk away???

I called several surgical offices and was quoted $2600. - $1500. for program fee. I kept looking. My surgical office charged $215 up front for materials. Prior to my surgeron meeting I was charged an additional $346 for coinsurance per the scheduler. I was then charged $1000. by the hospital for my deductible. Of course the hospital bill is the last one to get to the insurance. In the meantime I have other charges (pre-op labs & testing) being applied to the deductible I already paid in full. Very frustrating. Bottomline is that the surgeons safeguard their services. They want to be paid upfront and request their cut. In the end I know the doctor's office will probably owe me a refund.

do u happen to be in the kansas city area? just everything you described sounds like what i was told although i'm sure there are a lot that are the same. anyway just curious.

Yes I do actually. This is coming from Dr. Stanley Hoehn's office (Shawnee Mission Medical Ctr). So what did you end up doing? Did you decide on a surgeon?

Imagine the situation with NO upfront fee, I can see people getting chicken and canceling right and left or rescheduling ad-infinitum. Part of the reason I went through with mine after being scared and alone for 2 days in a hotel is the fact that I already had a sizable investment in the process.