Program Fee (to surgeon) & WLS

[Notmywil 0]

Were any of you required to pay a "Program Fee" to your bariatric surgeon prior to WLS? This is a fee that is not reimbursable by flexible spending (pre-tax) accounts. This is a fee paid to a bariatric surgeon who is a preferred provider for my plan. My health insurance has already approved the surgery. This fee is not covered by insurance and they require cash or credit card payment. What do we get for this $500 fee? Nothing....based on information from this bariatric surgical group's former patients.

:thumbup::redface:

[excarolinagirl 0]

I was required to pay a $150 program fee during my first visit to my bariatric surgeon.

[Notmywil 0]

How recently? What did they tell you this fee was for?

[excarolinagirl 0]

About a month ago. They told me it was a "program fee" and to bring it with me to my first visit (along with my meds, questionnaire, insurance card).

[Ariel 1]

yeah I had to pay $500. I think it is a major major scam but I wanted the surgery and all the hospitals in my area charge the fee. I don't think it is fair, I feel like it is the hospitals way of sticking it to us.

[Mr. Green 3]

The group that I am working with has a $395 fee if you want to join there program. This includes monthly seminars, weigh ins, etc. Basically, all the stuff you need for insurance to get approved. You can avoid the fee and go to your PCP, but I think going with the group can give you that edge. They coach you on all kinds of stuff and give you a ton of info.

[mi_illusion_st 27]

IM trying to change insurance and get a different provider because the one provider that IS covered by my current plan charges a 3000$ yes thats right 3 thousand dollar program fee.

[Julia_N 2]

Wow, I've never heard of this. My doctor charges me my regular co-pay for each visit, and I have to pay specialists their co-pays when I see them. In fact, as part of the agreement for my doctor accepting payment from the insurance company, I can only be charged a hospital co-pay of $500 per year. If I happen to have already paid that earlier in the year, they can't bill beyond what they accept. But that's just my insurance. Check with your insurance carrier and see if the doctor can charge you that.

[Notmywil 0]

You should report that doctor to your insurance company with a formal complaint and let them investigate. Somebody needs to bring some heat on these greedy doctors!

[lalaredd 0]

Don't feel bad cause I had to pay $700.00 but the dr. office broke the payments up, the fee had to be paid before the surgery date.

[Vidahlia 0]

I had to pay a $290 :biggrin: program fee... that covered the Nutrition class, Pre-op class and all the literature they handed out as well as an inexpensive little pedometer... I was hoping to add it to my medical expense list at the end of the year for a deduction on my taxes....:thumbup:

[Ariel 1]

In my case it wasn't the doctor that charged the money, it was the hospital. They say it goes to paying for the nut, admin fee and programs but my insurance covers all of that stuff. It's a scam, but what can you do when every major hospital in the city does the same?

[littlefroggy 0]

My doctor did it too. They also said you got a water bottle - whoopty doo- but I didn't get that. I'm self pay, so it was one more thing to pay. I just paid it because I really wanted to have my surgery at that hospital.

[CMTurner 0]

I was charged $350 which covered 2 nutrition education classes (which were required before you could meet with the surgeon), one on one nutritional counseling and dietary evaluation, and for gathering and sending in paperwork to the insurance. This fee also covers 5 yrs of follow up nutritional counseling and group meetings.

[*slim* 2]

I was charged two fees. The first fee was $95 (my part from $250) which pays for the consult, filing insurance, some kind of online educational class, and my pre-op class. I still had to pay $95 to the hospital for the nitritionist visit and psych evaluation. The second fee was $1000. I have no idea what exactly it covers (apparently not much since I still have to pay for fills), but he was the most experienced surgeon under my insurance. The other doctor under my insurance only did gastric bypass until this year. He did my gall bladder surgery and did NOT do a good job when it came to my incisions. So out of pocket to my surgeon's office was $1400 ($305 was my 10% co-insurance).