mlfsandiego

I was banded 5/18 as a self pay and had my procedure done in a surgery center. I paid the surgery center $8,500.00 and my surgeon $6,800 before the surgery as my band wasn't covered because I am low BMI. Today I received from my insurance company an explanation of benefits stating they have been billed for "supplies" at the rate of $9,500.00 from the surgery center. I then called the surgery center to ask what this charge was for? I was told that since I had a hiatal hernia repair (which I didn't even know I had until my post op check up) that they billed my insurance for that and I will be getting a separate bill from my surgeon for his part to repair it. I understand the part about my surgeon being paid to repair it, but how could the surgery center possibly rack up $9,500 in supplies for a 2 stitch repair? I am livid!! They are double dipping. I already paid to be operated on with anesthesia included and they billed my insurance company for a whole other surgery and expect me to pay the $1.532.00 of unpaid ins. deductible plus a $1500, co pay! I told them that this is a scam and double dipping and flat out insurance fraud. I told them I wanted a detailed list of "supplies" and was told that they bill globally for a procedure and don't count up each bandaid used. I am awaiting a call from their administration and flat out refuse to pay them for a whole other surgery! Unfortunately my insurance has already paid them their portion to the tune of $3,900. I intend to fight this all the way and let a judge decide if need be. This is the reason healthcare is so expensive. These kind of people bill and overbill as much as possible and get away with it. I also, plan to talk to my insurance company today to dispute this claim and hopefully they will investigate them. Sorry for the vent, but I cannot believe the greed in this situation.:thumbup:

Sounds a little too tight to me. Especially if you are flying.

Mine never loosened. I waited 4 weeks and It was like torture kept holding out to loosen. I lost 10 lbs, but I was almost in tears everyday. My surgeon told me to never wait that long. It's not supposed to work like that.

Sounds like you a little too tight! I just went through a month of this and had a slight unfill of .5 and I feel much better and plenty of restriction.

I was banded 5/18 by Dr. Sunil Bhoyrul in La Jolla. He is an excellent surgeon and practices at Scripps. Excellent Dr. and Excellent Staff. Approx. $15,000. includes first year fills. I was self pay with bmi of 33. I have lost 25 lbs. 10 weeks out. I wouldn't use anyone else and was referred to him by another doctor.

I am in the same boat!!! I am so pissed off to say the least!!!! I have been fighting the surgery center and asking how they can charge for a whole complete other surgery when I already paid them $8,500.00 cash for my surgery happening at the same time same location. My surgeon didn't charge me anything for the repair, but the surgery center billed my insurance $19,000.00 and my deductible plus co pay were almost $4,000.00. I complained to the insurance company BS and they said it is legal. Everybody wonders why our premiums are so high??? This is disgusting!!!! abuse of our healthcare system. I have perfect credit now and will probably go to collection because I told them I had no intentions on paying them. I asked them in writing for a complete detailed billing for both surgeries, then I intend to ask them how they can charge twice for everything like anesthesia, OR, etc., then I will ask it to be refunded to me. I have had screaming matches with these people already. :party: Good luck and I will keep you posted on my situation. Monica

My first fill was 3 weeks ago and it was 4 cc. I had a little be of a rough time the first week and a half, then I got used to it and I have been fine since. You should definitely feel the restriction and its just a matter of getting used to it.

Yes I have insurance, but does not cover Bariatric Surgery for my low BMI. It's not the fact that I had a hernia repair that I am upset about, It's the fact that they charged a complete surgery in the amount of $9,500 just for the Hernia in addition to the $15,000 lapband surgery.

I think there is a really good chance with enough weight loss it will go flat. I had my first child at 21 and the next at 27 then 39. I had gained 70 lbs. with the first and I lost all of the weight and my stomach was flat til I gained weight again through pregnancy in my late 30's. My friend had twins in her 30's and thought her stomach would never be the same. By the time the twins were 2, her stomach went totally flat with workouts.

I was self pay and paid about $15,500 in total. $8,500 to surgery center and $7,000 to surgeon. 2 months later I get this explanation of benefits from Blueshield stating the surgery center charged my insurance co another $9,500 for Hiatal Hernia repair and my surgeon charged $0. Basically the surgery center is trying to charge a whole other surgery and double bill. I am disputing this claim. How can a surgery center charge for a complete surgery when the surgeon isnt even charging for it. It requires a couple of extra stitches and done at the same time same incision as LAP-BAND®. Bottom line is I have been hit with an additional $4,000 in insurance deductible and co pay for the Hernia that btw I didn't even know I had. Beware when you start handing out your insurance card. Stupid billing people at surgery center answer "we global bill" which means it doesn't matter if you are already under anesthesia, with a paid OR and same incision, you are billed for every procedure you have at full price!:confused:

Update: Thanks for all of your replies! I called my surgeons biller today to ask her if this is normal for the surgery center to do this and she didn't know, but what she did say is that my surgeon wasn't going to even bill me or insurance for hernia repair as he just fixes them as an accomodation to his patients:biggrin: How nice is that? I then promptly called the surgery center and asked once again to speak to the administrator and was stoned walled. I got her voice mail and once again said that it was insurance fraud and that I don't see how they can charge for a whole other surgery when my own surgeon isn't charging for it? Also, I demanded a phone call back to resolve this issue. Unfortunately, they did not call me back, so I called blueshield my insurance company and explained exactly what happend and they are investigating this and will be fighting this claim. I hope they stick it to them! What a bunch of greedy bxstards!

I had my first fill June 20th and I was really tight for a week or so after. There was no way I could have eaten filet. 2 weeks out and am able to eat just about anything I THINK, but I havent tried filet yet. Mostly fish, bacon, & a little chicken. Pasta cut up is probably a better choice.

Last thursday (6 days ago) I went to the doctor for my first fill 4 weeks post op. I was able to eat anything and everything prior to fill. My doctor decided to be a little aggressive and fill me 4 cc. He said that I could either tough it out or he could unfill me a little. I decided to tough it out. The restriction was really high the first 2 days and now 6 days later, I am only able to drink liquids and Soups or anything through straw. I tried to eat some fish soft halibut last night and was stuck for almost an hour. Is this normal? When should I be able to eat salad, or soft fish, etc? Do I need to get a little taken out? Or does the band loosen in time and I will be able to eat small portions soon? Thanks in advance! Monica

I was banded a month ago 5/18 and had been feeling the same way. Losing a bunch preop and gaining most of it back within the first month. I went for my 4 week post op and first fill. I had kept 6 lbs off and my body fat had reduced 3 pts. I could eat anything and everything for the last 2 weeks. The doctor ended up telling me he was proud of my results and decided to fill me 4 cc's. I definitely have restriction now and have lost 2 lbs in the last 4 days. Be patient. The first month is focused on healing your body. Good Luck! Monica

I just had my surgery with Dr. B on May 18th. He is the best! Surgery center was excellent! Sorry can't help with the insurance problem, but the above post was correct $6,500 surgeon fees that includes one year of fills I think. I paid cash for the whole thing and the Surgery Center was $8,500.00. Good Luck!

I am getting that same exact pain. I think you are correct i thinking it only happens when I eat a little too much. It doesn't feel stomach related, but I think it must be.