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Money Up Front. Des Peres

Anyone have to come up with co-ins upfront. Even with my insurance coverage Im going to end up owing about 2900 up front. I just hope they take payments. At least I got 6 months because I have to do the diet plan.

Anyone else going to DesPeres hospital in StLouis Mo?

The also want a 75.00 fee upfront that's not billable to insurance?

Im a medical coder and Im sure this is legeal just seems like money grubben?

Any thoughts?

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Most surgeons and anesthetists require their fees be paid up front. After they figure out what your insurance will pay, they will figure what you owe above that and charge before doing the surgery (co-insurance and any deductible not already met). If there happens to be any overpayment...lol...you are refunded that later. Not sure about the hospital stay charges. I also work in the medical field and have seen it over and over, plus having gone through this for cardiac catheterization too.

My surgeon requires the co-payment and "year after" stuff one week before surgery. Hospital, I haven't heard anything yet.

At Healthy4life out of Hobart/Munster there is a $600.00 up front, not billable to insurance fee.

Every month you see their weight loss specialist/internist (six months program) and he gives you a diet to follow, exercise, Water plan - basically high Protein, low carbs, 64 ounce a water a day and 10k steps a day. You have to track all that and bring it in once a month. There was one one mandatory Group Meeting, and one Weight Loss Surgery: "Is it right for me?" seminar to attend, psychological testing, and meeting with their psychologist.

The first $200.00 is due when you meet with the nutritionist the first time at about 4 months who has reviewed the 4 months notes, you discussed your weaknesses, and what you may have to work on. . From here on out, I have open access to see the nutritionist for life. I can make an appointment any time or call at any time to discuss my needs.

The second $200.00 is due after you are approved by the insurance company when you go in to the two Pre-op classes which discusses the surgery again in detail and discusses the diet and they give you 14 days worth of Meal Replacements (42 shakes/soup/puddings) that you will need before surgery. So that $200.00 pays for your 14 days pre-op shakes.

The third $200.00 is when you see the Nurse the last time before surgery and she goes over everything once more, she will teach me how to clean out the drain, she will teach me the spirometer, answer any last questions. The nursing staff is available via phone 24 hours a day after surgery, and we can make appointments to see them or call them if we have questions or concerns at any time. Tomorrow is that meeting. I start my 2 week liquid on May 21st and surgery is June 4th.

For life there are free monthly group meetings with special topics, including special speakers, there are meet and greets with patients that have undergone surgery, they have special times for clothing swaps, they attack special topics and there is an annual Christmas dinner for all the patients. There is also discounted membership to a local fitness club associated with the hospital, discounted personal trainer meetings.

I have BCBSIL which will pay 90% of most charges, and I also have Medicare A&B due to illness. Unfortunately, their hospitals are not "Centers of Excellence" in bariatric because healthy4life switched from Methodist Hospital to St. Mary's/Community and they have to get re-certified. Also, Medicare hasn't fully approved the sleeve yet. I will have to pay 10% of the surgery plus the $600.00 up front. I'm really hoping some of the charges will end up going through medicare because the surgery could run higher with issues. I have to have a hernia repaired and I have extreme scar tissue/adhesion issues to deal with.

I'm having my surgery at Des Peres Hospital on Monday. My surgeon is Dr. Follwell. My insurance won't pay because there is an exclusion. I am self pay. I had to pay the surgeon up front 6,000.00. I'm financing the rest. I'm been approved for the loan and they just have to figure out how to bill the card... lol They aren't so sure. I've been around and around with the hospital about the financing. Still not too sure how it will work. I'm waiting for them to call me for pre registration to get the rest of the details lined out. Here it is a week away and I've not heard from them. I'm kind of worried about it but trying to not think about it. I want to get this done. I'm a medical biller also. Most of these hospitals want everything up front. Sad but true!

  • Author

Thanks for your replies eveyone!

Im realy hope I can work it out.

It makes sense but it sucks too! ;)

From my experience with other surgical procedures, you have to pay the surgeon's fee up front. Most hospitals will work out a payment plan for your share of the charges. They will expect some kind of down payment before surgury. For example, I paid a $500 deposit for gallbladder surgery and they billed me for the rest.

Most want everything up front with WLS since it is an elective surgery.

I was told Des Peres hospital only wants your deductible and in patient copayment up front. My deductible is met for the year and my inpatient is $250 I think. The rest I will get billed for. Dr Minkin did have a $75 fee plus my specialist copayment the first time I saw him.

  • Author

A rep called me the other day from doctor mMinkins office. They want co-ins upfront plus 75. Deductible later considering they do not know how thart will be processed. I go see Dr Minkin on the 30th. I hope a qaulify for the sleeve! Alsio Im going to if I can put 500 down then pay off the rest later.

  • Author

Fyi Im on my phone please ignore typos. :)

The first thing the insurance coordinator does at the surgeon's office is contact your insurance company, confirm coverage and find out the deductible/copay for the doctor's fees. They will do this again closer to the surgery in case you've met some or all of your deductible. Doctor's typically except full payment of your part up front. Hospitals are a separate matter. They will probably call you (usually the day before) wanting all or part of your projected part of the cost. You can negotiate with the to make a down payment and then once the bills have been submitted to insurance and they have paid, you will be billed for the remainder. Then you can work out a payment plan with the hospital.

JustSleeveMe, I'm like you. I had my gallbladder removed this year so my out of pocket should already be met and I won't have a copay.

  • 2 weeks later...
  • Author

At my first appointment today! 6 months to go.

  • Author

Everything went well I found put they will fix my hiatl hernia while they are in there. Its looking like I will be a sleever in Nov or Dec Merry Christmas to me!

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