Fills

Beth · August 2, 2003

I had my first (I am pre-band) consultation today with Dr. Borao and he said that insurance companies do not cover fills. He does them under Flouroscope and that they pay for the radiologist but not the fill Doctor. He charges $250.00 I am curious to know what others pay to see if this is the norm.

leo · August 2, 2003

That should be about right. I am going to have a fill in Tijuana and it cost $150. But once you factor in the plane ticket and hotel stay it comes out to about $600 dollars.

Alexandra · August 2, 2003

Beth, different insurance companies see things differently. I've heard of situations where all fills and followups through the first year are covered. I've heard of other situations where only one "adjustment" is included, and others where the fills are treated as completely separate procedures that have to be approved on their own.

I think there's a VERY strong argument that can be made to an insurance company when it comes to fills. If they approved the device in the first place, they should also cover at least three followup/fill visits. These are a NECESSARY part of the process to make sure your device is working properly. They'd never deny a doctor's visit to adjust your pacemaker, right?

I take it you're in NJ? Who is your carrier? And have you been approved?

Beth · August 2, 2003

Yes I am in NJ and my carrier is HealthNet. Dr Borao has said that he has no problems with HealthNet. He does not send anything into the insurance until I get a psych evaluation, have seen a nutritionist, and had an EGD (esaphogastroduodenoscopy) as they are required by the ins. co.

He says he is a "preffered provider" for them concerning the Lap Band and has even performed the procedure on two sisters who work for HealthNet, I believe he said they handle the coding? He says HealthNet is one of the only providers he has no problems with. Lucky me, I was sure I would be in for a fight. But then again, it aint over till.......well... you know what they say.

roxanne · August 2, 2003

I saw my Dr. on Thurs. and he said he charges $50.00 a fill and dosen't even submit to insurance company anymore because the fill is always denied. Roxanne

Jennaband · August 4, 2003

I am getting my first fill in two weeks. My Dr. charge 350.00 for the first fill. They want us to stay in the office for 1 hour post fill in case it needs to be adjusted. Then if we have to come back for an adjustment it is 100.00 from there on out.

Note: I had my band done in Mexico so this is not the Doctor who placed my band.

There is a ocal Doctor who does bands but her refused to fill someone he did not band.

He charges twice as much for the banding but then all the follow up is free for one year.

I still think I got the better deal.