Were is all my Chattanoogians at?

[*slim* 2]

I did have to do a psych evaluation and a nutrition class. They sent me to Memorial for that. It was $95, but that paid for both of them. The people at Memorial said that it would have been $50 if we were using their surgeons. I didn't get that, but I guess we are never supposed to understand the inner workings of billing and insurance. Also, supposedly, 4 or 5 more visits with the counselor and also use of Memorial's exercise facilities are included with that.

[Carrie_C 9]

Since I'm doing self-pay, I'm trying to nail down all of the costs. I even shopped around for my Upper GI - I had it done at Dalton Imaging for $225 (referred by Dr. Ponce). It was at least a hundred dollars more at Chattanooga Imaging. They filed with my insurance but I don't have a lot of hope that my insurance will pay it.

Other that your consult and your pre-op diet, were you required to do anything else prior to surgery (psyc eval, etc) and if so was there an additional cost?

I had to do a nutrition and psych eval. It was required by my insurance, but they require both for everyone regardless of insurance or self pay. I had to pay $95 and it included both consults. They didn't bill my insurance for any of it. That is probably what you will have to pay, unless they have increased to fee. There is also lab work and an EKG. I am not sure of the price for those, though, since my insurance covered it. But your insurance might pay for those.

[downsdc 0]

Thanks for all of the info. I'm trying to get myself mentally (and financially) prepared. My consult with Dr. Ponce is 8 days away (10/14). I'm leaving for a cruise vacation the next day (scheduled long ago) so I won't be able to do any pre-op until after 10/20. I'm almost tempted to wait until after the holidays, but at the same time I want to get started. My wife is a teacher, so she will be on Fall Break and will be able to go with me to the consult.

[Carrie_C 9]

They are very high cost. I had accepted in my mind the first fee that they quoted me. I was not ready for the extra $1000 "fee" that they charged me on top of my 10% coinsurance. I don't understand how they can have any type of fees that can't/won't be charged to insurance. That is just so over the top. You would think that with the amount that they charge, the first year of fills should be included in the price.

I don't know when you were last there, but Johnna had her band placed. She has lost quite a bit of weight. I almost didn't recognize her at my 1 week appointment.

I don't understand how they can charge a $1000 "program fee" either. They said some of it was for the support groups. But I live in Cleveland, so I am not about to drive almost an hour to a support group. I asked the insurance company about it, and they said as long as they told us up front about the fee and we agreed to it, then they can legally charge it. I think they are just taking advantage of people. They also charged me a $75 consultation fee on top of my $30 copay. I don't understand that either.

I didn't know Johnna was getting a band. I haven't been there since July. I go Wednesday for my fill.

[downsdc 0]

I was told my consult is $250 and I also have to pay $1000 down to schedule my surgery. As far as I know the $1000 reduces the cost I was quoted ($14,900). But I'll be sure and check. I don't want any surprises.

[Carrie_C 9]

That wouldn't be so bad. I guess I was so excited about everything else, I didn't think to ask about the cost of fills. I had assumed (never assume) that they would be like regular office visits since they do them there at their office. I found out later that they filed them as procedures. I don't know how my insurance will handle that.

They file them as procedures, but my insurance is telling me that all I am supposed to be paying is my $30 specialty copay since it is being done in the office. But they are trying to charge me a lot more. I am going to tell them that when I go in. I don't want to be difficult, but I am not paying any more than I have to. I have already paid them enough.

They also told me that there would be no charges the first 90 days, but that was a lie. I didn't have to pay for the first followup or the first fill, but they charged me $60 for the second fill and it was within the 90 days. So just be prepared. What type of insurance do you have?

[Carrie_C 9]

I was told my consult is $250 and I also have to pay $1000 down to schedule my surgery. As far as I know the $1000 reduces the cost I was quoted ($14,900). But I'll be sure and check. I don't want any surprises.

The consult was $250 for me too, but my insurance paid some of it. The $1000 is the program fee. They made me pay it one week before surgery.

[*slim* 2]

I don't understand how they can charge a $1000 "program fee" either. They said some of it was for the support groups. But I live in Cleveland, so I am not about to drive almost an hour to a support group. I asked the insurance company about it, and they said as long as they told us up front about the fee and we agreed to it, then they can legally charge it. I think they are just taking advantage of people. They also charged me a $75 consultation fee on top of my $30 copay. I don't understand that either.

I didn't know Johnna was getting a band. I haven't been there since July. I go Wednesday for my fill.

She had it at the beginning of September I think. I know when I went to pay for my part of the surgery, she had already had it. She looks amazing.

I was told my consult is $250 and I also have to pay $1000 down to schedule my surgery. As far as I know the $1000 reduces the cost I was quoted ($14,900). But I'll be sure and check. I don't want any surprises.

The $1000 probably is a part of what you were quoted. I had to pay that on top of my portion of my insurance charges. I was also charged the $250, but they billed all but $75 to my insurance. I ended up paying $95 of that.

[*slim* 2]

They file them as procedures, but my insurance is telling me that all I am supposed to be paying is my $30 specialty copay since it is being done in the office. But they are trying to charge me a lot more. I am going to tell them that when I go in. I don't want to be difficult, but I am not paying any more than I have to. I have already paid them enough.

They also told me that there would be no charges the first 90 days, but that was a lie. I didn't have to pay for the first followup or the first fill, but they charged me $60 for the second fill and it was within the 90 days. So just be prepared. What type of insurance do you have?

I have BCBS of Illinois. I was afraid that I would end up being charged for things that I was told was included. I don't understand that at all. I don't know if it is a problem with Johnna handling the insurance, or if it is them trying to get over on us. It is just really hard to tell.

[Carrie_C 9]

I don't know either. I just wish they would get my account straighened out. I have Cigna.

[*slim* 2]

Well, you keep me posted about how they handle that. I don't know if we are going to have to form a revolt or what. Surely if we complain or something, they can either explain it better, or do something about it.

[Carrie_C 9]

Yes, I agree. I am going to find the papers I signed when I first went there, and see what they say. It might have said that I will be charged more for fills than what my insurance is paying, I really don't remember. I will let you know what I find out.

[downsdc 0]

Just got my EOB back from BCBSTX for my upper gi. They paid all of it! At least I got the insurance company to pay for something...I still have to pay over 15K myself.

[*slim* 2]

Yeah! It is a small victory, but I victory all the same!

[*slim* 2]

I'm glad that you mentioned that. I just went to my insurance company's website. They have the EOB for my upper GI and my surgeon. They paid all of the upper GI. They paid all but $182 for the surgeon. They had already had me pay $305 for my part so they owe me some money.