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Question regarding Self-Pay Fills

I have a question to ask your opinion of... I thought I knew which way I was going to go, until tonight. So, I thought I'd run it by the forum in a couple of places, to get your valued opinions.

I am self-pay, went to Detroit for surgery. Fills were covered for 90 days. Anyway, the cost of us driving there, hotel, etc. adds up of course; After 90 days, the fills are $150.

I've received info here regarding fills about 45 minutes from me for $95. at a center.

Then, I called a very personable Doc who was recommended here (he's 5 minutes from me at a local hospital. I called his office to inquire if he'd do my fills. He called me back personally and provided me with his pager #, which I've used twice & he's called back quickly in both instances. Anyway, his office charges $130 and will attempt to bill your insurance. However, he has a $500 (self-pay fee) to take over your care - to become your band doc. You can call on him from now on end for all f/u band care and he sets you up with a nutrionist, if necessary.

Question: Would you pay the $500? Or just go to the center for $95.

Thanks for your feedback.

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I have a question to ask your opinion of... I thought I knew which way I was going to go, until tonight. So, I thought I'd run it by the forum in a couple of places, to get your valued opinions.

I am self-pay, went to Detroit for surgery. Fills were covered for 90 days. Anyway, the cost of us driving there, hotel, etc. adds up of course; After 90 days, the fills are $150.

I've received info here regarding fills about 45 minutes from me for $95. at a center.

Then, I called a very personable Doc who was recommended here (he's 5 minutes from me at a local hospital. I called his office to inquire if he'd do my fills. He called me back personally and provided me with his pager #, which I've used twice & he's called back quickly in both instances. Anyway, his office charges $130 and will attempt to bill your insurance. However, he has a $500 (self-pay fee) to take over your care - to become your band doc. You can call on him from now on end for all f/u band care and he sets you up with a nutrionist, if necessary.

Question: Would you pay the $500? Or just go to the center for $95.

Thanks for your feedback.

I would call the insurance company and see how much/if any the insurance will pay for the fills. This would be a factor that should be know before making the decision. Also you need to check out the place for $95.

You then have to decide which is better, the difference in costs for the fills for the 45 minute drive time. The $500 would pay for 5 fills right off the bat at the $95 place. I myself would go for the $95 if they check out.

Question: Would you pay the $500? Or just go to the center for $95.

Thanks for your feedback.

Just pay the $95. But it's nice to know you have someone who will take over the care- IF you need them.

I will cast a dissenting vote. I would definitely pay the $500 and go with the guy 5 minutes away. There is a big difference between being filled and being cared for. This doc has already shown himself to be personable and responsive, and he's nearby in case you have any problems. Having someone nearby assume responsibility for your care is great and I think important, and differs from someone just completing the technical aspect of your fills. It sounds like an ideal situation to me. Peace of mind? Priceless.

  • Author

My insurance Aetna HMO doesn't cover my fills; however the $500 explained that they submit the first claim for fills just to make sure. If the insurance denies, I'll need to pay the $130 for fills.

I can really understand the answers about the $95. center; and for the most part, I'd take it and run . But, I've been a bit worried about not having a doc to help if I didn't feel good about something with the band, so I am leaning towards the $500 doc.

Both places are highly recommended her on and obesityhelp.

I really, really appreciate everyone's honesty. I need this to make a decision.

I am a firm believer in "you get what you pay for" I would pay the $500 for the care of this Dr. Especially if you are questioning it!! Go with your gut:thumbup:

Riky

  • Author
I am a firm believer in "you get what you pay for" I would pay the $500 for the care of this Dr. Especially if you are questioning it!! Go with your gut:thumbup:

Riky

I appreciate this sound advice... needed to hear it.

Well I guess my question is what exactly is the $500 for? I could see if there was a whole bunch of initial start-up evaluations that needed to be done that is time consuming, but a new band patient is pretty cut and dry unless you have band complications or lengthy medical problems. It seems to me like you would be paying $500 just for the priveledge of being one of his patients. I would think a good doc would waive that fee just for the addition of a new patient that brings him income. Have you ever paid that kind of $$ when searching for a new PCP? But I guess the convenience of his location would be very important to me as well. And you seem impressed with your dealings with him so far which says alot. I was just playing devil's advocate for argument's sake. Best of luck to ya.

  • Author

Thanks everyone; I went with the personal care from the doc who is about 10 minutes or so away. So far, it's well worth it. I liked his explanations, he provided me with his email and let me know he likes updates and insists on corresponding.

The fill went great!

I also had my band at the same place you did in Detroit, and would kill for a personable close by doc to treat me. I live almost three hours north of there. If you don't mind me asking, where did you find your new doc? Not that the Drs in Detroit aren't well respected and good at what they do, but there scheduling service stinks!!! Two times I've had cancelled appointments for no reason, and a hard time rescheduling. Also my last appointment in December was "lost" somehow and the doctor was in Florida, of course I find this out after I drive three hours to get there, no one could call me and let me know they were cancelling my appointment. Luckily there happened to be another Dr there from the practice to see me and give me a fill. I would have went with the one you chose also, by the way. Good luck.

  • Author

I found two places in Chicago (well, I got the info from this board); Where do you live?

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