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What this program fee about?



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PLEASE feel free to send me a private message if you have any questions about Hopkins. The surgery and hospital staff was awesome, but the road to it was not always smooth(not their fault directly). One thing I will tell you about Hopkins is that they won't hold your hand, so be very proactive. Make all your appointments(nutrition,psych) asap because they are a really busy program and it will just prolong your wait if you drag your feet(experience talking).

Good luck!

Linda

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Hello All I am new to the site and I paid $500 to my surgeons office...I have did all the tests but, still have Psych. eval and Nutri. to see in July....My BMI is 36.3 but, I have hypertention, Type 2 diabetes, sleep apnea I have BCBS of Maryland HMO (Blue Choice) I did the six month diet...I was wondering if they have you do all these tests which I have done EKG/Echoardiaogram, Chest X-ray, abdominal ultrasound, Endoscopy, Colonocopy, Pulmonary Clearance, Sleep Study why would any Insurance denie you...I haven't been approved yet because I still need the Psyc eval ...Could someone please answer this question or give me some information on this PLEASE!!!! Thanks so much Stacey

Edited by harleyhottie0612
wrong information

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one of the drs I called had a $2500 program fee not billed to insurance, setting up chart, blah blah, after I heard the not billed to insurance I turned off my brain... then I would have to pay 10% of the billable part. I couldn't afford that at all.

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Stacey - it sounds like all those extra tests are required by your surgeon. BCBS had on their qualifying list the 6-month diet, psych eval., BMI>40 or BMI>35 with 2 co-morbids. I didn't have to do those extra tests besides that -----thankfully!

Also - BCBS in general tends to approve/not approve pretty quickly - so stay in touch with them. I called and they'd approved it within 3 days.

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Hey everyone, I just wanted to say hi to my fellow Marylander's... I am having my surgery at GBMC with Dr. Liao. My husband and I are both having our surgery through him... we really like him. My girlfriend had Dr. Mo and her surgery turned out great. She has lost 137 lbs and looks amazing.

I would love to chat with other Maryland's to hear their experience!

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Hey everyone, I just wanted to say hi to my fellow Marylander's... I am having my surgery at GBMC with Dr. Liao. My husband and I are both having our surgery through him... we really like him. My girlfriend had Dr. Mo and her surgery turned out great. She has lost 137 lbs and looks amazing.

I would love to chat with other Maryland's to hear their experience!

Hi Jaimie! Welcome! I was banded June 5th at JHU - Bayview - it went really well. I have heard good things about GBMC - I almost went there because I work in Towson.

Do you have a date yet? It sounds great that you and your husband are doing this together - it will help.

Feel free to send me a message if you want to talk.

Good luck - Linda

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    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
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