Aftercare programs

fsvasquez · February 8, 2005

I chose a surgeon to perform my surgery and just found out that he charges a $3500-$4000 "aftercare program" fee that is mandatory, not covered by insurance, and due at least 2 weeks before surgery. I thought this sounded extreme and I found another surgeon who charges $750 for basically the same program. The first surgeron told me that this fee covers fills for 2 years, a support group, dietician, and "access to him and his staff." I was told by the office of the new surgeon that fills are usually covered anyway by BCBS if they cover the surgery, and that I shouldn't have to pay for "access" to the staff.

I'm just a little confused about all of this and not sure if this is something that every surgeon charges or what. I was wondering if all of you have had to pay some type of fee like this, and if so what did it normally run?

Thanks,

Sara

leatha_g · February 8, 2005

I did not. It sounds like revenue generating tactics to me, whether you actually use the services or not. Do you have the option to NOT participate?

If he takes your insurance, he should have some contract worked out with them for what he charges for this procedure and it's follow up. My dr's office was not allowed to charge anything for the first 90 days following my surgery. So.. I tried to get as many fills as I could in in that time to get me back to a good restriction.

It might be worth a call to your insurance company to see if this acceptable practice for those who are contracted with their company for this particular procedure.

New Hope · February 8, 2005

Hmmm, sounds a little like the "dealer prep" charges when you buy a new car. If your insurance covers the band surgery, they should cover your follow-up care. Good for you for finding out BEFORE you got stuck w/that surgeon.

blossom · February 8, 2005

Hmmmm....sounds pretty shady to me!

Alexandra · February 8, 2005

I think I answered you back on Spotlight, and my answer is the same here. You have the right for your medical care to be covered by insurance, and a lot of what is in the aftercare program is MEDICAL CARE. Office visits and fills should be eligible for insurance coverage, no matter how your doctor chooses to bill you.

If your doc is participating with your insurance plan, you might want to call your carrier and see how they want you to handle this. My guess is that if they get more than a few calls about this he'll be told to stop.

Penni60 · February 8, 2005

Since when do we have to pay to attend a SUPPORT GROUP meeting. Those are volunteer run and from what I understand no one is charged at the one Billy runs. They are FREE. This surgeon is a shister in my book. That is outrageous. It sounds like he is wanting to get paid for what the insurance won't cover on the band by disguising it as his "aftercare program". I would run from this guy. I would also report him to your insurance co and possible the AMA as well.

I have ZERO tolerance for these types of doctors now. They are just out for the money and don't seem to want to help the patient. SIGH!! Sorry got on my soapbox there for a minute.