PROGRAM FEES

[APRPro4U 2]

OK, this is ridiculous.

As of January 1, I will have Anthem BCBS -- a huge improvement over Tricare Prime. I think I can wait until then. I am exercising and treating my body better by eating more fresh foods and watching portions size.

But THIS news shocked me today. Dr. Keshishian of Glendale, CA charges a $4,000 "program fee" to patients. I am disgusted. He is considered one of the best and yet he is involved in a practice that insurance companies find unethical and grounds for dropping him from their insurance policies.

Have all of you paid these fees?

This link shows all the insurance carriers he takes: http://www.obesityhelp.com/profiles/bariatric-surgeon/dr-ara-keshishian/#profile_insurance

Now I know why. If he accepts all those, he can then collect $4,000 from each of patient -- on top of what each insurance company pays.

I genuinely feel this is discrimination against the obese. Cardiac and Cancer patients are not charged fees in addition to what insurance pays. Why us? Because of my media contacts (I'm in PR), I am ready to write a press release, distribute it and see how the doctors feel when this info is public. I know the insurance companies do not support doctors charging fees beyond what is covered in the policy. This has to stop or people will die because they don't have the money.

It's a tight economy and paying $4K just to get heatlthy seems wrong. Am I missing something? Thanks in advance for your constructive answers.

M

[Cindy C 150]

That's absurd. Find another doctor. My program fee was $100.

[54Shirley 105]

I would find another Surgeon. Look for a Center of Excellence in your State, and City..> or Neighboring City.

They set their rates ! If you want to go public and expose possible Fraud. That's up to you, but be prepared for a probable

Court Case.

Will people die because they can't afford the 4K ? NO! They will do further research, and go some place else.

I'm sure this man will continue to lose money do to ridiculous rates.

If I were you,,, I would find another Doctor..

[njm 0]

Check out California Bariatric in Arcadia. No program fee and the doctors are great.

[jen120 23]

I see you live in HB. I live in Cypress. I had my surgery at St. Joseph's in Orange. They are a center of excellence. It is an awesome facility, no program fee. My surgeon was Dr. Johnsrud. They are a very comprehensive program. They have support groups 2x a month. You do have to pay 1 time (since it is not covered by insurance about $130) to see their nutritionist but after that you can see or talk to her as much as you want. The staff are great.

Also, I have Anthem Blue Cross and they required a 6 month Dr. supervised diet before approving the surgery. If you are going to wait until January, start your supervised diet now with your primary physician. Let me know if you have any questions.

[Phranp 46]

I also have Anthem Blue Cross and I live in L.A. I TOTALLY am against the outrageous "program fee", but many docs do it because BC pays VERY little to them for doing lap band surgery. I had to go to FOUR surgeons before I found one that would do it for what BC pays. But, the issue here is that the doc gets the money from the patient, not the insurance company ... and he doesn't care. I echo what the others have said FIND A NEW SURGEON.

People are all jazzed about having a lapband surgeon that is "one of the best". Ask around, lap band surgery is just NOT THAT BIG OF A DEAL. There are hundreds of LB surgeons that have done this surgery THOUSANDS of times and, unless you can find evidence that they have killed even a small percentage of their patients I think that would probably make them "one of the best". Don't get the idea that I think it's not important to have a good/excellent surgeon. I had back surgery in 2004 and my orthopedic surgeon asked for a neuro spinal specialist do the surgery while he assisted. A friend who had family in "the business" checked him out for me -- he was GREAT. So, it's not that having "one of the best" to do your surgery isn't important, it's just that IMHO, there are so many surgeons that qualify (for lapband) that you can find a surgeon that does NOT gouge you with a $4,000 program fee.

I wish you the best and I hope you can find another excellent surgeon. I believe you can, after all, we live in So Cal where there are a zillion doctors. LOL

~Fran

[Phranp 46]

BTW, the surgeon I ended up with not only did not charge a "program fee", but he didn't even charge a co-pay when I went in for fills. AND, he wasn't the most experienced lap band surgeon ... he was a general surgeon. I have not had a problem and I haven't been back since I hit my sweet spot over a year ago!

[PJ384 3]

Perhaps instead of sending out a press release why not use your contacts to get a expose published on the doctors who do this practise and include a list of doctors who do not do this so people in the area will be well armed with the information to avoid being ripped off but greedy doctors.

OK, this is ridiculous.

As of January 1, I will have Anthem BCBS -- a huge improvement over Tricare Prime. I think I can wait until then. I am exercising and treating my body better by eating more fresh foods and watching portions size.

But THIS news shocked me today. Dr. Keshishian of Glendale, CA charges a $4,000 "program fee" to patients. I am disgusted. He is considered one of the best and yet he is involved in a practice that insurance companies find unethical and grounds for dropping him from their insurance policies.

Have all of you paid these fees?

This link shows all the insurance carriers he takes: http://www.obesityhe...ofile_insurance

Now I know why. If he accepts all those, he can then collect $4,000 from each of patient -- on top of what each insurance company pays.

I genuinely feel this is discrimination against the obese. Cardiac and Cancer patients are not charged fees in addition to what insurance pays. Why us? Because of my media contacts (I'm in PR), I am ready to write a press release, distribute it and see how the doctors feel when this info is public. I know the insurance companies do not support doctors charging fees beyond what is covered in the policy. This has to stop or people will die because they don't have the money.

It's a tight economy and paying $4K just to get heatlthy seems wrong. Am I missing something? Thanks in advance for your constructive answers.

M

[honk 780]

Just so NO to program fees. The first hospital I went to had $600 fee. I called a much higher rated hospital that was about 15 minutes further away (total of 45 minute drive) and they had no fee. Guess where I went?

[stateofzen 46]

That's a huge fee-- what do you get for it?

I do think program fees often go to pay your support staff-- your nutritionist, your counselor, and other professional staff who help you through the process who are not allowed by the insurance companies to bill for their services. I would be willing to pay program fees if I knew that it wasn't going into the surgeon's pocket, but was going to actual services above and beyond the surgery and fills. But then again, you better be getting A LOT of extra services for 4 grand!

[spoiltmom 44]

Find another doctor. I had ZERO program fees. None.

When I think of weight loss and program fees I think of Jenny Craig, Weight Watchers, Nutrisystem. I do not think of Lap Band surgery because IMO it should not have program fees attached. You and your insurance company pay enough for it without you paying extra.

[APRPro4U 2]

So I must share with you....

Thank you for all your kind words of support. I am grateful.

Let me also say when I posted the same message on ObesityHelp, I was attacked by every person who responded. I ultimately deactivated my profile.

As it turns out, I will likely need a D/S (duodenal switch) and not a lapband (too long a story) because I have 9 yrs ago I had a lap gastric bypass. But at the end of the day, charging these BS fees to morbidly obese patients who have insurance just seems wrong.

Again, I am so happy you are so supportive.

M

[spoiltmom 44]

I totally agree with you. It's definite BS. If I pay that much I better be getting a personal chef to take home with me and prepare all my meals for the first 6 months. LOL

[healthychange 1]

Don’t pay it. And don’t waste your energy fighting it. Just move on and find an excellent surgeon who won’t charge you a program fee at all. There are plenty out there.

BTW – I have Blue Cross Anthem as well. Every plan is different, just like every surgeon is different. I chose a surgery center that would take care of all the insurance paperwork and pre-approval for me. My first visit was on June 6, and I was approved within 4 weeks. I had my surgery on July 28. I did not have to do any kind of supervised diet.

OK, this is ridiculous.

As of January 1, I will have Anthem BCBS -- a huge improvement over Tricare Prime. I think I can wait until then. I am exercising and treating my body better by eating more fresh foods and watching portions size.

But THIS news shocked me today. Dr. Keshishian of Glendale, CA charges a $4,000 "program fee" to patients. I am disgusted. He is considered one of the best and yet he is involved in a practice that insurance companies find unethical and grounds for dropping him from their insurance policies.

Have all of you paid these fees?

This link shows all the insurance carriers he takes: http://www.obesityhe...ofile_insurance

Now I know why. If he accepts all those, he can then collect $4,000 from each of patient -- on top of what each insurance company pays.

I genuinely feel this is discrimination against the obese. Cardiac and Cancer patients are not charged fees in addition to what insurance pays. Why us? Because of my media contacts (I'm in PR), I am ready to write a press release, distribute it and see how the doctors feel when this info is public. I know the insurance companies do not support doctors charging fees beyond what is covered in the policy. This has to stop or people will die because they don't have the money.

It's a tight economy and paying $4K just to get heatlthy seems wrong. Am I missing something? Thanks in advance for your constructive answers.

M

[54Shirley 105]

We pay good Money to these Ins. Companies.

They pay these Dr.'s and Medical Facilities a fare amount of money, and they settle for it ""AGREEMENT" If they were not getting paid decently ? No one would want to choose that field to work in.

So with that in mind, why should you dig deep, and pay extra money ?

It's not like we agree to pay them only so much for Ins., and they are agreeing to it. We pay the full Bill !

So why should you pay extra ?

I would check with my Ins., and see if I were required to pay this fee for Bariatric Surgery ! If not ! ! ! Turn his Greedy @ss in to your Ins. Company.