Fill Centers USA ... problems and questions

[delrio 0]

Hey all,

If you're familiar with Fill Centers USA, I'd like your feedback regarding their fill policy. They say if you get an overfill, you can come back within 72 hours and get it emptied at no additional charge. However, for underfills, there is no protection and you're charged an additional 165.00!! This doesn't seem fair. My doctor (the only Fill Center doc in Utah) is conservative, and I got a fill yesterday and I'm still feeling no restriction. Any comments or suggestions?

Also, when I signed up for their services a couple of years ago, they promised me 150.00 for fills. Then they upped their rate despite their statement that fills would always be 150.00. This also seems shady to me. But they stood their ground.

[coltonwade 27]

I dont know their policies and i dont use them (My doc does my fills) But it woudl be nearly impossible for ANYONE to promise a free fill " after so many hours if it did not work . how would they make their money?

First off Fills can take up to 2 weeks to kick in . So what are they suppose to do say " Ok if your fill does not kick in after 2 weeks you get another one for free ? " how would they make any money ? that's the whole point of fill centers ?

Honestly be lucky they offer free unfills after 72 hours if yoru too tight. THAT is nice ! If i need an unfill even a slight one I have to pay another $125. I dont mind though my doc is my doc and he has to make a living and make money . I do not think its unfair for them to charge you again for a fill.

There is NO WAY after 24 hours you can know if your fill has kicked in . My fills do not kick in for 4-7 days typically .

HTH

Mindy

[delrio 0]

I dont know their policies and i dont use them (My doc does my fills) But it woudl be nearly impossible for ANYONE to promise a free fill " after so many hours if it did not work . how would they make their money?

First off Fills can take up to 2 weeks to kick in . So what are they suppose to do say " Ok if your fill does not kick in after 2 weeks you get another one for free ? " how would they make any money ? that's the whole point of fill centers ?

Honestly be lucky they offer free unfills after 72 hours if yoru too tight. THAT is nice ! If i need an unfill even a slight one I have to pay another $125. I dont mind though my doc is my doc and he has to make a living and make money . I do not think its unfair for them to charge you again for a fill.

There is NO WAY after 24 hours you can know if your fill has kicked in . My fills do not kick in for 4-7 days typically .

HTH

Mindy

Mindy,

First of all, I think it's rape to charge anywhere near 100.00 bucks or more for 5-10 mins. work. There may be a few exceptions, but my fills have never exceeded 10 mins. I don't care what the doctor is doing. Fills are a ripoff to begin with, especially in the US. Doctors in the US who charge this amount or more do so because they can, not because they've earned it. They know that patients need multiple fills, and many patients can't get back to their doctors in other countries. They also realize that there aren't a lot of doctors filling patients from other countries. So they take advantage of that. They're milking patients for every dime. I've seen specialists for hour long visits and have never been charged 165.00. If specialists don't make that in an hour, how do doctors justify charging it for 5-10 mins. work? Especially since the majority of fills are uncomplicated? If a fill doesn't go well, fine, attach a 10.00 fee or something. 165.00 is exhorbitant. Furthermore, what's the required training for giving a fill? A few hours? A couple of days? It's not as if they've invested themselves extensively to learn how to do a fill. Many nurses do fills, so it doesn't even require an MD to do them.

Your fills may take 4-7 days. However, my fills are either working or not within 24-48 hours. This has been consistent with 8 fills. I've been told by 3 doctors that 1-2 days is usually how long it takes for patients to know whether or not the fill is correct. Furthermore, since the Fill Center has a policy of 72 hours, there must be something to that time frame, don't you think? If 4-7 days out was typical, and they wanted patients to have fills corrected accordingly, their policy would be likely to reflect that.

What doesn't make any sense at all is that they cover overfills, but not underfills. I don't see a difference. If the fill is inaccurate, it's inaccurate. Futhermore, they've never been able to justify this policy to me. If you've got a policy, be prepared to provide clients with a reasonable explanation for it.

I guess my question to you is this: since fills are always iffy, and it's difficult to tell immediately following a fill whether or not it's working (meaning within an hour or so), it's safe to say that the doctors usually guess. If they're guessing and they're wrong, why should the patient be further burdened? If both parties know that the doctor is merely estimating a fill, one or two adjustments are NOT unreasonable to expect within a reasonable time frame. I think you're right that 1-2 weeks is unreasonble, but not 72 hours. However, if it was an exact science, and the patient specifically requested 3cc's for example, then that's different. If the patient is certain that their choice for a fill is correct, and they're wrong, fine then, let them pay for the correction. I never go in for a fill requesting a specific amount. I discuss my symptoms with the doctor and he guesses. Why is it impossible to promise additional fills then? What's unreasonble? 2 additional adjustments *might* take 30 mins. total, and that's being generous. I don't think 30 mins. justifies 165.00 either.

So how would they make their money? Well, what's reasonable for 5-10 mins. work? 20? 30? 50? At least we're in a reasonable range here. If they charged 30.00 and did 6 fills an hour (which isn't untypical), that's 180.00 and hour. That's still outrageous (again, the specialists don't make that). But at 165.00 a fill, 6 fills and hour, they're making 990.00 an hour! Who makes that?? You'll never convince me that doctors are worth 990.00 an hour, I don't care what their specialty is. But 180.00 an hour isn't a bad living, most people could live comfortably on that, even today. I think it's a little ridiculous to suggest that if they weren't charging huge amount of money for fills, that they wouldn't be able to make a living.

These outrageous charges for fills are nearly exclusive to the US. It's merely another illustration of greed withing the medical community. Not all doctors are greedy, but those who are seem insatiable. When lap bands were finally approved for the US, prices skyrocketed (for the surgery, not the hospital costs, which were added on top of that). Today, they've more than doubled what is charged in other countries. Is that reasonable? Are surgeons who have performed a procedure 500 times worth twice as much as surgeons who have performed the procedure thousands of times? I don't think so.

So no, I'm not feeling lucky that I'm making some greedy doctor ridiculous amounts of money because he knows he has me over a barrel. In fact, as I mentioned earlier, it feels like financial rape. That's not a good feeling. Ever.

Anyone have thoughts on this?

Edited January 4, 2009 by delrio

[luckyfive101 6]

I thought my fill was too small also.. I think you will find about 2 weeks after, it seems to tighten up... I actually thought I was going to have to have an un fill 2 weeks later! I managed through it though and found my "sweet spot".. Good luck!

[delrio 0]

I thought my fill was too small also.. I think you will find about 2 weeks after, it seems to tighten up... I actually thought I was going to have to have an un fill 2 weeks later! I managed through it though and found my "sweet spot".. Good luck!

Hi there,

Thanks for the feedback! That makes me hopeful. In the past, my fills have been pretty consistent in that if they're not working within a day or two, weeks later they're still not working. However, this may be an exception! I'll pay close attention and cross my fingers that the fill will tighten up.

[coltonwade 27]

I thought my fill was too small also.. I think you will find about 2 weeks after, it seems to tighten up... I actually thought I was going to have to have an un fill 2 weeks later! I managed through it though and found my "sweet spot".. Good luck!

Which goes back to what i said it can take UP TO 2 weeks for a fill to "kick" in or tighten up .

Mindy

[coltonwade 27]

Mindy,

First of all, I think it's rape to charge anywhere near 100.00 bucks or more for 5-10 mins. work. There may be a few exceptions, but my fills have never exceeded 10 mins. I don't care what the doctor is doing. Fills are a ripoff to begin with, especially in the US. Doctors in the US who charge this amount or more do so because they can, not because they've earned it. They know that patients need multiple fills, and many patients can't get back to their doctors in other countries. They also realize that there aren't a lot of doctors filling patients from other countries. So they take advantage of that. They're milking patients for every dime. I've seen specialists for hour long visits and have never been charged 165.00. If specialists don't make that in an hour, how do doctors justify charging it for 5-10 mins. work? Especially since the majority of fills are uncomplicated? If a fill doesn't go well, fine, attach a 10.00 fee or something. 165.00 is exhorbitant. Furthermore, what's the required training for giving a fill? A few hours? A couple of days? It's not as if they've invested themselves extensively to learn how to do a fill. Many nurses do fills, so it doesn't even require an MD to do them.

Your fills may take 4-7 days. However, my fills are either working or not within 24-48 hours. This has been consistent with 8 fills. I've been told by 3 doctors that 1-2 days is usually how long it takes for patients to know whether or not the fill is correct. Furthermore, since the Fill Center has a policy of 72 hours, there must be something to that time frame, don't you think? If 4-7 days out was typical, and they wanted patients to have fills corrected accordingly, their policy would be likely to reflect that.

What doesn't make any sense at all is that they cover overfills, but not underfills. I don't see a difference. If the fill is inaccurate, it's inaccurate. Futhermore, they've never been able to justify this policy to me. If you've got a policy, be prepared to provide clients with a reasonable explanation for it.

I guess my question to you is this: since fills are always iffy, and it's difficult to tell immediately following a fill whether or not it's working (meaning within an hour or so), it's safe to say that the doctors usually guess. If they're guessing and they're wrong, why should the patient be further burdened? If both parties know that the doctor is merely estimating a fill, one or two adjustments are NOT unreasonable to expect within a reasonable time frame. I think you're right that 1-2 weeks is unreasonble, but not 72 hours. However, if it was an exact science, and the patient specifically requested 3cc's for example, then that's different. If the patient is certain that their choice for a fill is correct, and they're wrong, fine then, let them pay for the correction. I never go in for a fill requesting a specific amount. I discuss my symptoms with the doctor and he guesses. Why is it impossible to promise additional fills then? What's unreasonble? 2 additional adjustments *might* take 30 mins. total, and that's being generous. I don't think 30 mins. justifies 165.00 either.

So how would they make their money? Well, what's reasonable for 5-10 mins. work? 20? 30? 50? At least we're in a reasonable range here. If they charged 30.00 and did 6 fills an hour (which isn't untypical), that's 180.00 and hour. That's still outrageous (again, the specialists don't make that). But at 165.00 a fill, 6 fills and hour, they're making 990.00 an hour! Who makes that?? You'll never convince me that doctors are worth 990.00 an hour, I don't care what their specialty is. But 180.00 an hour isn't a bad living, most people could live comfortably on that, even today. I think it's a little ridiculous to suggest that if they weren't charging huge amount of money for fills, that they wouldn't be able to make a living.

These outrageous charges for fills are nearly exclusive to the US. It's merely another illustration of greed withing the medical community. Not all doctors are greedy, but those who are seem insatiable. When lap bands were finally approved for the US, prices skyrocketed (for the surgery, not the hospital costs, which were added on top of that). Today, they've more than doubled what is charged in other countries. Is that reasonable? Are surgeons who have performed a procedure 500 times worth twice as much as surgeons who have performed the procedure thousands of times? I don't think so.

So no, I'm not feeling lucky that I'm making some greedy doctor ridiculous amounts of money because he knows he has me over a barrel. In fact, as I mentioned earlier, it feels like financial rape. That's not a good feeling. Ever.

Anyone have thoughts on this?

The only thing i have to say is that you sound hostile towards ME over this policy .

I pay my doctor for an office VISIT and the fill each time i get a fill. We discuss how things are going for me , what im eating ect. It takes longer than 10 minutes.

My doc has ALWAYS said and i have heard from others fills can take up to 2 weeks to either get the FULL affect or to realize they did not work .

I am not trying to be rude but If you did not like the policy before hand then why go to them ?

each person is different when it comes to the band. I dont see how they could possibly set a policy for the band fill or unfill for that matter, ( which is what i meant its lucky they dont charge for unfills ) for people when it comes to fills.

Fill centers , in my opinion make money from people who were banded else were and either did not set up after care else where before hand or need after care.

Are they taking advantage ? Probably .

However most people i know hwo are self pay pay around $100-$150 per fill . Is it right ? I dunno . I do know the docs make more money from the surgeries than they do the fills.

As for your question , I have NEVER EVER had a fill that I have known with in an hour if it will work for me or not . One way or another , if it was going ot be too tight or not . NEVER has that happened to me. I have had fills tighten up on me as long as a month out . Is it safe to say docs usually guess ? to a certain extent yes.

my doc would laugh at me if i walked in there and said " HEY give me such and such amount of a fill " He would look at me like im nuts . It all comes back to if you did not like fill centers policies then maybe you should not have gone to them ?

that's my input

Mindy

[Bamagal 1]

well I have to admit I often feel they are just bleeding money from us on fills and this is why.If fills are included in the price of banding I have noticed they get bigger fills and find their level of restriction sooner than those of us that pay for fills.

Then there is the the odd thing of losing a 1/2 cc of fill ever time from the last fill so even though they say they gave you 1cc it only raised you .5 because they say you lost that .5 but yet they are not concerned about it as it is normal?Then you have to wonder are they bleeding by giving you only .5 or are they being cautious?And why the tale of the lose of .5 cc is it to keep you happy thinking yo got 1cc when you really only got .5? Who knows but we have to trust them to take care of us so they do have us over a barrel in ever since of the word.

I pay $75.00 for an office visit and then another $75.00 if I get a fill,I do see the NUT.

[coltonwade 27]

well I have to admit I often feel they are just bleeding money from us on fills and this is why.If fills are included in the price of banding I have noticed they get bigger fills and find their level of restriction sooner than those of us that pay for fills.

Then there is the the odd thing of losing a 1/2 cc of fill ever time from the last fill so even though they say they gave you 1cc it only raised you .5 because they say you lost that .5 but yet they are not concerned about it as it is normal?Then you have to wonder are they bleeding by giving you only .5 or are they being cautious?And why the tale of the lose of .5 cc is it to keep you happy thinking yo got 1cc when you really only got .5? Who knows but we have to trust them to take care of us so they do have us over a barrel in ever since of the word.

I pay $75.00 for an office visit and then another $75.00 if I get a fill,I do see the NUT.

Did i read this right ... they tell you you have lost .5c''s EVERY Time you get a fill ? If that's the case something is wrong and you might have a leak ! you should not be losing ANY Fluid every time you get a fill. Its normal to have lost a small amount of Fluid over time . Maybe ONCE in a while but not EVERY Fill. My fills were included in my first yr . But im still getting fills and unfils ( i have a sensitivty to fills ) Some fills i have to get under flouro still to check the band . But sometimes my doc waives that fee.

What it boils down to is trust. You have to trust the person your going to. If you dont trust the amount they are putting in ask them to see the syringe. Ask them to pull out what is in there now so you see exactly what you have in your band. I know exactly what is in my band, what goes in and what comes out every fill. My doc shows me .

Mindy

[lapbandtalker 0]

Hey all,

If you're familiar with Fill Centers USA, I'd like your feedback regarding their fill policy. They say if you get an overfill, you can come back within 72 hours and get it emptied at no additional charge. However, for underfills, there is no protection and you're charged an additional 165.00!! This doesn't seem fair. My doctor (the only Fill Center doc in Utah) is conservative, and I got a fill yesterday and I'm still feeling no restriction. Any comments or suggestions?

Also, when I signed up for their services a couple of years ago, they promised me 150.00 for fills. Then they upped their rate despite their statement that fills would always be 150.00. This also seems shady to me. But they stood their ground.

Dr. Muse was aggressive with me. (the Utah center location) Only took 2 adjustments to get to goal. He followed INAMED's guidelines to the letter. I was so worried, like you, that I'd get a doc who wouldn't follow the guidelines...in my mind-to make extra money.

The book says 2cc in a 4cc band and then .5 after that....well, that's what I got.

After I met goal I went back to get a slight unfill because I was 10 pounds under goal and all it took was 1 adjustment-unfill. My weight has remained stable since(+/-5 pounds).

My suggestion is be an informed consumer. Read the book that came with the band (your surgeon should have given it to you). When you get your first adjustment 6 weeks after surgery you KNOW before you get there how many cc's you are going to get. If you aren't getting it-ASK why you are not getting the recommended fill.

Your doc is working for you on this. If you want to be aggressive, your doc should assist you in this. If you want to take it a bit easier, he should help with this as well.

Edited January 7, 2009 by lapbandtalker

[coltonwade 27]

Dr. Muse was aggressive with me. (the Utah center location) Only took 2 adjustments to get to goal. He followed INAMED's guidelines to the letter. I was so worried, like you, that I'd get a doc who wouldn't follow the guidelines...in my mind-to make extra money.

The book says 2cc in a 4cc band and then .5 after that....well, that's what I got.

After I met goal I went back to get a slight unfill because I was 10 pounds under goal and all it took was 1 adjustment-unfill. My weight has remained stable since(+/-5 pounds).

My suggestion is be an informed consumer. Read the book that came with the band (your surgeon should have given it to you). When you get your first adjustment 6 weeks after surgery you KNOW before you get there how many cc's you are going to get. If you aren't getting it-ASK why you are not getting the recommended fill.

Your doc is working for you on this. If you want to be aggressive, your doc should assist you in this. If you want to take it a bit easier, he should help with this as well.

I too got 1.4ccs in a 4cc band the first fill and it got restriction w/ that . I have had issues w/ my fills and myself being sensitive w/ them but since then i got .5 or .25 cc's .

Not everyone is going to get to goal w/ 1 or 2 fills. But I agree if a doc is giving you .5 cc fills every fill something is not right. They are milking you and I would raise hell !

HTH

Mindy

[Bamagal 1]

Did i read this right ... they tell you you have lost .5c''s EVERY Time you get a fill ? If that's the case something is wrong and you might have a leak ! you should not be losing ANY Fluid every time you get a fill. Its normal to have lost a small amount of Fluid over time . Maybe ONCE in a while but not EVERY Fill. My fills were included in my first yr . But im still getting fills and unfils ( i have a sensitivty to fills ) Some fills i have to get under flouro still to check the band . But sometimes my doc waives that fee.

What it boils down to is trust. You have to trust the person your going to. If you dont trust the amount they are putting in ask them to see the syringe. Ask them to pull out what is in there now so you see exactly what you have in your band. I know exactly what is in my band, what goes in and what comes out every fill. My doc shows me .

Mindy

Today had another fill he took me to 8cc's and I had 6cc's of the 6.1 that was suppose to be in there so I am not really concerned I have a leak,ask the doc about the lost cc's and again he assured me not to worry he don't really know where it goes.He said fills are not an exact science sometimes we have air in the band that has to work itself out,and maybe sometimes he loses part of a fill pulling it out and it is even possible for the port to lose a smidgen while it is healing so unless we lose alot he just don't worry about it.Dr.Wizman is not only a doctor but a Proctor aswell so yes I do trust him and his experience.I am sure in his years he has seen it all.

Edited January 9, 2009 by Bamagal

[coltonwade 27]

Today had another fill he took me to 8cc's and I had 6cc's of the 6.1 that was suppose to be in there so I am not really concerned I have a leak,ask the doc about the lost cc's and again he assured me not to worry he don't really know where it goes.He said fills are not an exact science sometimes we have air in the band that has to work itself out,and maybe sometimes he loses part of a fill pulling it out and it is even possible for the port to lose a smidgen while it is healing so unless we lose alot he just don't worry about it.Dr.Wizman is not only a doctor but a Proctor aswell so yes I do trust him and his experience.I am sure in his years he has seen it all.

If you go back next time and you have less than 8cc's I would question it. I do not believe it is normal to lose saline EVERY TIME you have a fill ! A tiny tiny amount maybe ? But I have had the exact same amount every time i have gone back for my fills! Some of the liquid can be trapped in the line between the port and the band, some might be air. But not every single time. proctor or not docs can make mistakes. its up to us to question them as well. So if you have less than 8cc's next time I would ask him to check your band under flouro just to b e sure !

Mindy

[Bamagal 1]

for the first three months when I got fills they were all under flouro and at that time I was checked for leaks placement ect.and as I said this time it was just .1 lost so little most would not even notice much less make a note of it but he is very attentive to ever small detail but yes if it much at this point I would be concerned after 8cc all the air should be gone.

[kimaly 57]

I use Fill Center USA and I've not had the problem with them being to conservative with mine, I'm a little less then 6mo. out and have had 2 fills and a slight unfill. I'm now at 4.4cc in a 10cc band with a 9cc fill level. And can't make up my mind on rather I need another yet or not. Some days I feel I can eat more then I should and other days I still get stuck or PB. So I've just been waiting.