PROGRAM FEES

[danaevett 179]

My surgeon is charging me two program fees that I'm just not sure of. The first was a $75 fee to cover the seminar and various other stuff. The second is $1000 due one week before surgery. The part that concerns me is that these fees will not be submitted to insurance. That seems a little curious. Also; I had to pay $95 for my Nutritional Evaluation and Psychological Evaluation which also was not submitted to insurance. They say that there will be no other fees. Anyone else think this seems odd?

[OKSleever 144]

My surgeon is charging me two program fees that I'm just not sure of. The first was a 75 fee to cover the seminar and various other stuff. The second is 1000 due one week before surgery. The part that concerns me is that these fees will not be submitted to insurance. That seems a little curious. Also; I had to pay 95 for my Nutritional Evaluation and Psychological Evaluation which also was not submitted to insurance. They say that there will be no other fees. Anyone else think this seems odd?

Mine did the same thing, though not as pricey. He charged $300 for unlimited nutrition and exercise classes with the argument that they're not covered by insurance and people weren't using them and thus weren't being as successful due to financial concerns so being the helpful guy that he is, he wanted to make sure money didn't keep us from getting follow up care. Sounds like a scam to me.

[Cupcake 801]

I agree with the above statement I would contact my insurance company as well as provide them with these prices to see why they are not coverage , they will eat you know for sure if its a fraud.

[SuzyB 182]

It does sound odd. I would want what the money is being used to cover. With OK sleever I would have loved to pay one fee for nutrition and exercise classes. That imo sounds like a great way to help one be successful. My program requires one NUT class and would love everyone to take a second but insurance does not require it.

[Kygirlkeshia 11]

My surgeon charged $250 at the first appointment and then another $250 at the next appointment. It was to cover the information seminar, and all the things insurance wouldn't cover since this isn't a mandatory surgery. It's really up to each office to charge what they want, but it wouldn't hurt to check with insurance

[RebecaSparkles 247]

My surgeon waives the program fee depending in what insurance you have.

I think its bs that you have to pay if you have the insurance that doesnt pay as well as others.

I'd try and fight it. Program fees dont make sense for sleevers who typically dont need many follow up visits/hand holding/office resources/ beyond the initial 90 days included in your original surgical fees.

[tigerbelle 328]

what was the $1,000 fee for?

[alittler09 47]

My office charges a $200 program fee.

[ReadyNewM3 112]

Odd....I didn't pay any fee...., but this amount I think is high...good luck!

[Brighteyes 237]

I paid my $25 co-pay for my pre-surgical consult. I haven't had anymore fees and I am finished with all my pre-surgical requirements.

[kerrysway 46]

I had to pay $1000 one month prior to surgery, this was my portion of the surgeon's fee as required by my insurance. I knew I would have to pay this so it didn't come as a surprise to me. Perhaps this is what is going on in your situation as well? I would get the surgeon's office to clarify exactly what that $1000 is for and, depending on what they tell you, maybe contact the insurance to see if any of the things included in that $1000 would be a covered benefit. If you get a "YES" to anything, I would then demand that the surgeon's office submit those charges to the insurance for consideration, it's no skin off their nose to click a few buttons to submit a claim. You'll probably still have to pay the $$ up front but if anything does get paid you would be entitled to a refund. Same goes for the NUT & Psych. visits. Good luck.

[Shells_Almost_There 357]

I had to pay $500 for my program fee, which covered the nutritionist, the sports therapy consultation, and all the appointments before the surgery. Then, they gave me an invoice "due 2 weeks before surgery" for $1400 which is my percentage of the surgeon fees that insurance won't be covering. Later on the day I was scheduled for my surgery, they called for their money! What I'm worried about are the extra costs --- the CPAP process/machine has an extra $250 deductible that I will need to come up with, the psych eval guy apparently was "out of network" (which his office didn't bother to mention or I would have gone elsewhere), so I am being charged an extra $250 deductible (!) and then the anesthesia and hospital costs are a mystery, but I'll owe either 10 or 15% of those costs. I'm estimating at least $2,000 out of pocket for those. Overall, this is an expensive process, even with insurance coverage, but I believe all the out of pocket medical expenses can be an itemized deduction on my taxes. I've never had to claim that type of deduction before, but I hope I can for 2013! Plus, all this being said, I think the surgery is worth it

[zenandnow 514]

Mine charges $5750 above & beyond what insurance covers. It's for the one year follow up care including NUT. But since she sucked I no longer go to her. Now fighting with the practice to get a refund.

[RickM 1,753]

I never got along with Dr. Cirangle's high program fee, as much of it covers things that would be covered by insurance if billed separately, like the follow up appointments - those are routine Dr. consults. I have no problem with some of the nominal fees charged by some to cover expenses that insurance doesn't cover. Some of those things can be very useful long term if they get us started in directions we may not ordinarily go (like exercise physiologist consults, or body composition testing) while some of it may be fluff. My doc doesn't charge a program fee, but covers those costs in his surgical fee which he doesn't normally discount by being "in network" for the insurance companies.

[Ljones1 48]

All my fees are paid by rhe Insurance company. And why should one have to pay for the FREE SEMINAR! For information. Check with your Insurance company.