Let me just say that I admire all of you that have had to self pay. I have to ask the question though...."if you were approved by your insurance and all cost were covered, but the doc wanted thousands more than insurance will pay, would you pay the difference?"

It depends on what the thousands covered. Some docs have a program fee to cover costs of aftercare that aren't covered by most insurances. My surgeon does. I was self-pay so I didn't have to decide if I was going to pay it. :crying:

But if you had insurance that says it covered and you go to a participating doctor and he wastes 2 months of your time to tell you he wants more, would you pay.

NO because it's illegal for an in-network doctor to do that. I would feel like if he was that greedy or dishonest that who knows what he might skimp on etc. No way. There are too many reputable surgeons out there to bother with one that is unscrupulous.

You need to wait and see what happens with tricare; but I think you'll probably need to find a new doc. Better you find out now that having problems post op, you know? I think he's probably a turkey.

No and I'd report him.

I'd probably threaten to bill him for the time he cost me.

I am going nuts waiting to hear back from Tricare and of course I have to wait til Tuesday. His office girl told me that even though he is a network provider (general Surgery), he is not contracted for Bariatric surgery and therefore they can charge. If that was the case then why did he accept my insurance for the Bariatric evalution? Kinda contradicting if you ask me.

I know you are very unhappy but I don't think you're going to find your answer here. You'll just have to either wait and see what tricare says, pay him, or find another surgeon. That will be your decision to make...no one here can make it for you.

Sound to me they figure you're going to want it bad enough to pay for it, rather than going to another surgeon. Doesn't sound very honest on his part.

I am not looking for an answer here I was just curious. When the office girl first presented the $$ amount difference I immediately started thinking of ways to come up with the money but it was after the emotions calmed down that I started to feel it was just plain wrong and he should not be able to do this. I have already picked out 2 surgeons to call tommorow. Thanks for the input

Lap band lady you are SO RIGHT!!!

Unfortunately the same thing happened to me in May. I went in for my pre-op and they wanted me to sign paperwork saying I would pay whatever Tricare didn't... which would have added up to several thousand.

The fact is that a Tricare network doctor can choose not to do "elective" procedures. I went round and round with Tricare and they said the hospital and doctor could refuse to take Tricare for the surgery. Technically they cannot balance bill, but you can sign your rights away, when I pushed the issue with the hospital they turned me away.

Where in Florida are you? I ended up having to go to Jacksonville, FL to get my surgery, which is 2.5 hours from where I like. It was unfortunate, because the other place wasted three months of my time.

I am in Melbourne.......where are you from?

I am in Valdosta, GA.

My doctor was out of network so I had to pay an additional $2000. I have to say it was the best money I ever spent! I am not hungry or craving bad things. I even started going to the gym. I am so glad I did this.

My in-network doctor accepts my insurance, but his partner does not and he does not do surgery with anyone else so I ended up paying out of network fees for that doc. Evidently, they do that with almost all insurances and that is how they make some extra $$. Honestly though, other than that, I love my doctor and it was worth all of the extra money paid, I would do it all over again.