$250 Class Before Gastric Sleeve Surgery

[Mel34 11]

my insurance covered everything besides a 20$ copay for visits and my 6 months of doc visits that i had to have before surgery. I wouldnt mind to pay extra for the weekly support visits and the access to the trainer and dietician, that would be pretty awesome!

Well i still don't know what all consists after the class is done, i.e. support group, classes, trainer and dietician. But if it does, I'm going to love it! I guess I'll just have to wait and see!

Have you tried asking if there is anything like that you can take?

[Wheetsin 714]

If you guys had/are having insurance pay for your surgeries, I would encourage you to call your provider and ask them about the fees. When a procedure is covered, there are legal restrictions in place that forbid your surgeon/healthcare provider from charging you for anything beyond the contracted rate. Even if the surgeon's office discloses the fee up front, or requires it in advance, call and ask. The sequence of things isn't as important as the comprehehnsiveness of the negotiated rate. I'm not guaranteeing it will make a difference, but insurance companies are very steadfast in their agreements that the patient does not pay beyond the negotiated rates, and that patients are not billed anything above & beyond.

[twoboysandagirl 109]

I had my surgery at a military treatment facility and I was required to take two classes a total of 3 hours I believe. I had to take and pass a test over the material. It was very easy so I wouldnt sweet it. For me the class was over all three surgeries they perform so I had to know stuff about a band and by pass even though I was having a sleeve. I hate that their is an added fee for you:(

[Mel34 11]

Yeah, the fee sucks, but I don't mind paying it if it's going to help me get through this and succeed.

[Mel34 11]

If you guys had/are having insurance pay for your surgeries, I would encourage you to call your provider and ask them about the fees. When a procedure is covered, there are legal restrictions in place that forbid your surgeon/healthcare provider from charging you for anything beyond the contracted rate. Even if the surgeon's office discloses the fee up front, or requires it in advance, call and ask. The sequence of things isn't as important as the comprehehnsiveness of the negotiated rate. I'm not guaranteeing it will make a difference, but insurance companies are very steadfast in their agreements that the patient does not pay beyond the negotiated rates, and that patients are not billed anything above & beyond.

Wheetsin,

Thanks for the information!!! I'm going to call them right now and find out!!! thanks so much!!

[UXgrrl 29]

My surgery was covered wholly by my insurance. I was required to take a 12-week healthy eating class (called the L.E.A.R.N. Program). It was run by the hospital department where I had my surgery. It was done in a group setting and met for 1 hour every week during the workday. I couldn't miss more than 1 class during this time or I would have to restart the program.

It was covered by my insurance as "outpatient mental health services" with a 10% copay. I also had to buy a textbook (I think it was about $25).

Before I began the program I did the psych eval, and then again with her after I finished (sort of an "exit interview"). I also met twice with a dietician and a PA for medical supervision. All the appointments counted as "specialist visits" which have a copay of $25 each visit.

Considering the costs that others have to bear for this surgery, I consider myself extremely lucky.

[former_vbg 198]

I couldn't concur with you more! I ended up switching surgeons because their office tried to pull a fast one on me which ended up being insurance fraud. I had and still have in writing where a Dr. in Denton, TX was supposed to NOT have any program fee's and I would ONLY be responsible for my deductible and co-pay amount which at that amount would have only been a few hundred dollars. TWO weeks before my scheduled surgery, they tried to tell me I needed to pay $2,000 to make up for the cost for my surgery that the insurance wouldn't cover. I immediately knew something was wrong. I was on the phone to Aetna quicker than you can say 1,2,3, was assigned a supervisor and that supervisor from Aetna even intervened on my half w/3 way calls to the Dr.'s office to find out what they were doing. They are NOT allowed to bill me for anything that they are contracted with the insurance for. They are REQUIRED to submit ALL services through them, and then once processed, then and ONLY then, are they allowed to bill me. This is the safety net for patients so they don't get reemed by the Dr.'s office. As much as I hate insurance companies in general, I really appreciated their help during that time. They were told what they were doing was not allowed. I have since turned that Dr. and Dr.'s office into the AG and the Ins. Commissioner for the state of TX. They are allowed to collect money for these stupid program fee's because they know the insurance companies don't cover them.

But, ALWAYS check with your carrier if you have any suspicions of what you are being billed/ asked to pay, ESPECIALLY, if its up front.

If you guys had/are having insurance pay for your surgeries, I would encourage you to call your provider and ask them about the fees. When a procedure is covered, there are legal restrictions in place that forbid your surgeon/healthcare provider from charging you for anything beyond the contracted rate. Even if the surgeon's office discloses the fee up front, or requires it in advance, call and ask. The sequence of things isn't as important as the comprehehnsiveness of the negotiated rate. I'm not guaranteeing it will make a difference, but insurance companies are very steadfast in their agreements that the patient does not pay beyond the negotiated rates, and that patients are not billed anything above & beyond.

[Mel34 11]

So I just called the insurance and the nice lady told me that if it's a class that is required and if it's held at the hospital, it covered by my insurance. I have federal BCBS. she said the insurance covers all Diabetic and Nutritional counceling. Now i'm going to call the doctor's office back and ask what and where this class is taking place...

I'm getting a little bit upset now... :-/

Former, Ex, and Wheetsin,

THANK YOU for the input!!!!