"Administrative Fee"

[FLbandgirl1985 0]

So I went to a seminar with the surgeon I am considering the other night and I found out that my insurance definitely covers lap band surgery so my out of pocket will be $150.00 for the out-patient surgery as well as any co-pays for testing.

However, the surgeon has a $3,700.00 "administrative fee" that is outside of what insurance pays for the surgery.

This covers things like their nutritionist, trainer, support meetings, 24/7 on-call nurse, website used to track your results, etc.

The program does seem like it's top notch - the surgeon is a training proctor for the lap band and realize band and goes around training other surgeons to use the system. He also participates in clinical trials and keeps a research nurse on staff. He is very into data and statistics and tracts EVERYTHING which was nice as he provided his statistics vs. general lap band statistics when it comes to surgical complications, etc.

He also keeps his own first assistant on staff for all his lap band surgeries to ensure the shortest surgical time possible and they've been working together for 7 years.

I was highly impressed with the surgeon and his staff -but $3,700.00 is still a lot of money.

What do you guys think? Is this common? Did you have to pay a similar fee?

If I can come up with the money I am pretty sure I will go ahead and with the procedure. I feel really good about the program, of course I'd prefer not to shell out $3,700.00 but I know there are a lot of you who'd gladly pay that vs. self funding the entire thing.

[Soexcited 64]

I'd pay it it sounds like a reasonable fee to me. We will be out of pocket for the whole thing so it sounds like a deal to me.

[Mimilou2004 13]

It sounds like highway robbery to me. I have heard of these program fees before and think that amount of money is crap. There are other fine surgeons out there who charge nothing extra or just a few hundred. Please keep your options open and check out a few more places.

Mimi

[mmh 0]

The doctor that I'm seeing charges a $375.00 fee for things like advertising, web-site maintenance, etc. I'm ok with it, but the fee you mentioned is extraordinary!!!

[RestlessMonkey 7]

I agree with Mimilou. It's highway robbery. Check around. And call your ins; see what their take is on it.

[Chele6378 0]

HECK NO! My surgeon offers a program thru iBariHealth and it's $99 a month and they come to my house, help me get all of my insurance requirements met and do the psych eval. $3,700 is an awful lot of money!

[annjones 3]

That does sound high, but I would say it all depends on your location and what kinds of costs the doc is having to pay over and above what insurance is paying.

My doctor's office has recently gone to charging 375.00 for an admin fee (before it was 0) But then I know that he also takes Medicare and Medicade<sp> patients and the reimbursement to his business from those places don't cover even half his COSTS. So the fee is instituted to help defer his costs in having quality medical care available for those in need. Paying something does help sometimes with people to feel more vested in what they are doing.

I'd talk to the office and see if they will work with you on payments or something, if you can't afford the whole amount up front.

Or check around and see what your options are.

[ParrotheadCathy 0]

BIG rip-off! For most of us, all that is includeded in the fee for the surgery. I'd shop around before I committed to that. They're just looking at you as a paycheck and that's their way of increasing the paycheck.

[Shar Pei 0]

No fees at mine and gives the first year of fills free.

[FLbandgirl1985 0]

Thanks for the input everyone.

From what I understand, this is the only surgeon that my ins. co. covers.

I have a health ins. plan that is a local company and it's basically a HMO. Apparantly this is the only surgeon in the area that is contracted with them so my hands are kind of tied. Either I shell out the $3,700.00 or no surgery at all.

I really don't have the money, I'll have to take out a loan (if I can get one). So, IDK :/ the thing that stinks is the ins. specialist at the surgeon's office said that my ins. co. is very straightforward as far as getting approval, as long as you have either a BMI of 40 or BMI >35 w/ at least 1 co-morbid. you can get it approved and they don't require a 6 month diet or anything.

On one hand it seems like a lot of $$$ but then at the same time it seems like a small price to pay for my health. Like I said, the program does seem top notch, but I can understand why some of you feel that it seems too high. I really don't know....

Edited September 14, 2009 by FLbandgirl1985