Paying a program fee?

[Cristay30 0]

New to the forum and find it very helpful! I've been thinking about getting the Lapband for the past three months. I finally went to a seminar to see what are the first steps needed to start the process. I called my insurance company (United Healthcare) and found out that they do cover the surgery with the normal guidelines. At the seminar I found out my BMI was 54, I have no co-morbidity and that with my age I was a very good candidate for the surgery. The question I have is.....that most of the weight lost surgery programs here in Ohio want you to pay a program fee. Some starting at $300...$500...even up to $800 non-refundable fee, and has to be paid before they will even submit to your insurance for pre-authorization. I'm not too sure in just giving up this money and not knowing for sure if my insurance will approve it. What should I do?

[Melissa S 1]

Yes, I had to pay a program fee of $600...which covers quite a few appointments and classes that I am required to attend. They said once I pay I can submit it to my insurance and they may reimburse me for some of it.

I would ask them exactly what the program fee covers.

[Kat817 19]

Wow---I would imagne it is due to how the insurance companies search for ways to end up denying us. The Dr.s way of comping themselves for the work entailed. But that's just a guess.

Be interesting to see if the trend is more widespread than just your areas!

Welcome to LBT. In my opinion---the band is well worth that cost. I self paid, and paid a lot more than that, and it was still worth every cent!!!

Kat

[TracyinKS 7]

There was a place here in KC that wanted $800 up front, but I found a surgeon on my provider network that does the Band and the only thing I had to pay upfront was $150 for the consultation.......... they submitted to insurance and last week I just got a refund check for $150 from the Dr.s office because insurance paid it.

[whosthatgirl 0]

There is a surgeon in my area who's fee is $2500!!

[whosthatgirl 0]

There is a surgeon in my area who's fee is $2500!!

[Wheetsin 714]

Wow, I'd say look around. I don't do non-refundable fees. If they can collect some amount of money from you, for doing nothing, what's their motivation to do anything else? Nothing. Surely there's another option... keep looking into it. There should be other options around.

[Candle 11]

If that fee covers all the pre-op stuff - I'd say it doesn't sound too bad.

If not - SHOP AROUND!

I've had to pay the shrink $250 + nutritionist $250 + $390 in co-pays ($30 per visit) and they haven't even submitted to insurance yet cuz I'm still working on the sleep study.

[violeteyes37 0]

Im in Columbus Ohio and Im using the Barix Clinic. Though I have not had my surgery yet, I have gotten my approval through UHC and what I have to pay is the maxium out of pocket deductible which is payable at the time I have my pre op. The only cost up front was my office deductible of 30. Not sure how far away you are but you may want to contact them. Their # is 1 800 282 0066. As has already been stated it makes since if this cost is going to be for pre op and will be coming off of what you have to pay anyway. But im still not sure if I would want to pay it upfront before you even get approval from the insurance.

[rrkeithsgirl 0]

I am in Virginia Beach, VA and had to pay $495.00 up front, but that has covered several things. Hope that helps!

[bandmeplz 0]

At first I went to Dr. Curry in Cincinnati and had to pay a program fee of $300. After I paid and got approved by insurance I decided that since they were out of network that I would go somewhere else for my procedure. I went to Dr. Schumacher in Dayton.....they do not charge a program fee.

Also, after I switched doctors, Dr. Curry's office staff was not so helpful to me and in fact rude. They would not answer my voicemails or emails and I had to call and actually talk to them three times to get them to fax my file to Dr. Schumacher's office. When they finally did fax it they didn't send everything that was needed - good thing I kept a copy of all of my records before sending them in. In my opinion it just made me feel like I had made the right decision in changing doctors to begin with.

I would highly recommend Dr. Schumacher and his staff you might want to check them out.

[Cristay30 0]

Thanks everyone for the input! Hey bandmeplz, I think I will take the advice and check into Dr. Schumacher. Dayton is about 30 mins from me....so that's close enough for me to check it out. Also what all did you submitt to Dr. Curry to get the ok and how long did it take?

[bandmeplz 0]

Cristay30 you have a PM

[dotofoz 0]

Try submitting to your flexible spending account if you have one. It may also be tax deductible, check out IRS publication 502, page 14 (I think).

[Lana24 10]

Ok who paid and how much did you pay? Mine is 2850...here is california