Program Fee

[rotide 0]

Did anyone else have to pay a program fee above and beyond insurance coverage? Mine was $3000.00, just wondering if unusual or not. Is there a way to get reimbursed from insurance for the fee?

[BetsyB 9]

Yes, but mine was only $300. $3,000 seems awfully high!

Do you have a flexible spending account? It may be reimbursable through that.

Most program fees are not, from what I understand, reimbursable through most health insurance plans.

[newdicarlo 0]

Mine was $375. $3000 does seem quite high. What does that cover for you?

[dlsmom1 0]

No program fee that I know of.

[dontgoggilme 0]

mine was $200. and i agree that $3000 does seem awful high. i'd definitely wanna know what my 3 grand was paying for!

[thinneranniesoon 0]

That is how the doc gets more money than what he is contracted with the insurance company for.

I know when I had my surgery the bill was $42k total, but insurance paid the contracted rate of $12k total. So they were out $30k.

Personally if the surgeon tried to this, I would have found another surgeon, they contract with the insurance companies at a set rate, that is what they have agreed to accept for the surgery, I can't believe that the insurance company will go along with this program fee issue.

[BigMomma 0]

My program fee was $1000. I filed it on my insurance and part was reimbursed and part was applied to my coinsurance.

[govikesgo 0]

My Doc wasn't in my network but took what the insurance paid. No out of pocket to him at all. I did however still need to meet $675 of my deductible for the hospital. he had nothing to do with that. That was from the hospital itself. Still not bad for a procedure that would have been $25,800 total.

[jldchester 0]

The first clinic I went to wanted a $1200 fee paid before they would even schedule surgery (included 16 classes) plus $500 up front before surgery. They would only take cash or credit card. No personal checks. I finally got feed up with them after paying for some of the classes that a nurse taught -while reading off a piece of paper. Needless to say I felt it was a racket and was all about the $$$$$$$. Then they started pushing you to buy the Vitamins they sell.(When at seminar - children's chewables were good enough) I finally got online and did some more searching - I found a clinic with no up front cost and felt they were really concerned about me and my health. I have to travel an hour and a half from my home, but it was worth it. I would suggest to keep looking.

[reneek 1]

Mine was $200 dollars which covered the cost of support meetings and things and i didn't mind paying because i knew that is wasn't for profit it was to help us stay on track. $3000 even though your insurance is coving the surgery should be considered fraud. I would never pay $3000. Your insurance is paying for your surgery, your doctors appointments, your fills. I would see another doctor. This doctor is just out to make money. What does this $3000 dollars cover?

Edited March 17, 2010 by reneek

[gbakerc 2]

to me any more than 0$ is a rip off. Just a profit center for them. My Doctor did not charge one.

[LapBandBobbi 8]

I did not have a program fee at all. I think it should be included in the total cost.

[PalmBayTish72 4]

There is a doctor here in Melbourne, Florida that charges a $3700 "program fee" upfront. Needless to say I went with a different surgeon,and there was no program fee and I am so happy I did. I go in for my first fill today! :scared2:

[jtreece 0]

That is really high for a program fee. I was self-pay and I paid a $500 program fee but that included my surgery consultation, psych eval. and meeting with nutritionalist as well as a binder of info. and support groups.

[RavenClaw779 2]

I went through Ellis (Albany, NY) - No program fee, but what they billed to my insurance carrier was incredible - $860 for the same lab work for which my regular doc charges $200.

I have my own nutritionist, but had to see their's - $380 for a recent college grad who read an post-op diet to me..

I agree with everyone who feels it's just another way to pad their costs. Check with your insurance carrier - sometimes by virtue of being insured by a particular carrier these little extras can be waived - esp with some help from your carrier.