Bariatric Practice Won't Tell Me What's in My Band?!

[RavenClaw779 2]

...and it's not that I don't want to know. My bariatric practice has told me they put X in, but on the next visit they tell me I have Y in...and I can do math; it doesn't add up. When I try to pin them down, I can't get a straight answer. My last visit resulted in the need for a slight unfill. When I asked the PA, "How much was in the band?" I got a vague, "A little over 5cc's.." and she dodged the question of how much she took out. Am I nuts to think that it's important to know in the event if an emergency? It's not like I can just pop over to my WLS on a whim, nor is he going to make a special trip over an hour and a half if I'm in my local ER and need the Fluid taken out.

Curious too - just saw the bill to my insurance carrier for my last fill - uncomplicated, quick visit - billed as "surgery" for $485!

Feedback Please!

[AlienBandit 10]

First off $485 for a fill????? That's crazy and over priced! They are probably just trying to get as much money as possible out of your insurance. It wasn't a surgery!

As for them not tell you the amount of your fill, I would be pissed! Each time I see my doc We discuss how much total of a fill I should have, what I have and what I will get. He then removes all of the Fluid and checks to make sure it is right. He then shows me the amount I had. Then he shows me the new amount he will fill me with and injects it into my port slowly.

Many doctors do the band surgery because they can make lots of money out of it but then complain about the aftercare because apparently they could be doing better things with their time then filling up patients. Hence why they charge so much for fills.

Since I had some problems in the past with my band, I always make sure to know as much info possible ( ie the amount of my fill) because I dont want to be filled too much and I dont want them to under fill me ( tell me I get a certain amount but not fill me to that amount therefore guaranteeing I would need to go back)

[BetsyB 9]

I understand your frustration--but no, it's not important information in an emergency. We all tend to fixate on the number, especially early on. But it's just a number, and rather meaningless, except inasmuch as it prevents overfilling. As long as they're keeping good records for themselves, there is no safety issue.

That said, I think you have the right to know the information.

(But I also suspect that as you get farther down the line, you'll care less about it. I have no idea what is in my band at the moment--not because my doctor wouldn't tell me, but because I didn't think to ask last time I was in.)

(The bill to your insurer doesn't startle me at all.)

[JennaJ221 2]

My dr tells me how much too voluntarily. I aslo got a phot copy of their log of my fills so I can see how much was put in on what date. They may just be scamming u. I would ask for copys of ur medical records..ur fills must be recorded. And by law they have to give it to u. I would also suggest finding a new doc. Good luck

[honk 780]

You have a right to your medical records. I would ask them nicely to tell you how much is in the band. If they won't tell you I would remind them that you have a right to know your medical details. Period.

Regarding the "surgery" lable. I had the Plantars Wart that Ate New England this year on my left foot. Took five months of PCP, Dermotologist and Pediatrist visits to take that sucker down. The statements I received from insurance after visits where they cut down the dead wart with a razer before treating it with acid were called "Surgeries". Those procedures cost $250. For a razer blade and some Eat Away Your Skin (literally) Acid.

[RavenClaw779 2]

Thanks everyone for the perspective.

Just got off the phone with BCBS(MA) - the claims adjustor told me that they will only pay "Reasonable & Customary" which by their standards for this procedure is around $57.00.

The CA told me that often the surgeon's office bumps the bill up because they know the R & C and the difference is used as a tax write-off. They do define "surgery" as "anything invasive" so a needle insertion would qualify.

Bet ya someone paying out-of-pocket for their procedure would not be handed a $485 bill for each fill - who could afford it!

Edited September 2, 2010 by RavenClaw779

[emjay 8]

Not sure why fill costs are so "all over the place". My fills were included in my package for the first 2 years and thereafter it's $50 per fill. Seems reasonable.

[TracyNYC 4]

I nicely requested to be moved to the other doc in the practice since he is on my plan. It was no problem. I never see him anyway. I always see his PA, who I love. The other doc has his own PA, so now I will see her in October. If I need a revision, the second doc is it. Now i will have a $20 copay instead of $283 per fill.

[SVM10 6]

I have the same problem at my doctor's office. I also live an hour and a half away from my doctor's office. I actually vented about it on the Labor Day Challenge board (didn't know this was here). I really don't know what's in my band. They seem to be guesstimating. I got the first 3 fills free with the surgery, but the rest are $150 each, of which insurance pays 80% and I pay 20%. My insurance also paid 80% for my surgery and I paid 20%. Why is it such a big deal about telling us what's in our bands? We deserve to know.

[minimeme 1]

...and it's not that I don't want to know. My bariatric practice has told me they put X in, but on the next visit they tell me I have Y in...and I can do math; it doesn't add up. When I try to pin them down, I can't get a straight answer. My last visit resulted in the need for a slight unfill. When I asked the PA, "How much was in the band?" I got a vague, "A little over 5cc's.." and she dodged the question of how much she took out. Am I nuts to think that it's important to know in the event if an emergency? It's not like I can just pop over to my WLS on a whim, nor is he going to make a special trip over an hour and a half if I'm in my local ER and need the Fluid taken out.

Curious too - just saw the bill to my insurance carrier for my last fill - uncomplicated, quick visit - billed as "surgery" for $485!

Feedback Please!

Call the practice and tell them you would like to come by and pick up copies of your doctors notes for your fill sessions. They have to provide them by law, although they might charge you a few pennies per sheet for copying fees.

I had an issues with a workers comp doc so I just started picking up copies of his notes and bringing them into the next appointment. That way we were both on the same page. No hidden agendas. :smile:

[kydman 0]

I may not have much to offer as I am just 4 days post op (banded) but my original paper work states that the first 90 days post op are included (fills) and after that they are $150. My BCBS insurance has approved this at 80/20 & after my $4000 annual OOP 100% so I assume my fill will be either the regular OV co pay of $20 or 20% of the $150 (which I'm sure is contractually adjusted) which would be at most $30.