Outrageous fill costs

[RestlessMonkey 7]

Insurance pays for my adjustments at a large well known medical place but they are very cautious and I haven't had great success for getting good restriction, so decided to try Fill Center and even tho they don't take insurance they are more reasonable about trying different cc amounts till your satisfied.

The hardest part I've found is when you get adjusted and they stand and watch you drink Water and you have to decide how its going down. Its just Water. When you leave and its 5 days later and your woofing down a sub sandwich and just paid out big bucks for restriction.

There should be a better way to get a good adjustment than just basing it on if you can drink water.

Anybody relate to what I'm talking about?

My doctor can tell by the resistance he feels withdrawing and inserting the saline and he's always been spot on with him telling me how I'll feel and what I can do. The water is just to make sure you can swallow your own saliva and stay hydrated, not to see if you can "woof down a sub".

[SpiritDriven71 1]

fills for me are 155. insurance pays for xray

[veronicagal 0]

Here in Austin, Tx @ True Results Centers are $125 a fill, might want to find a True Results Center close to you. Good Luck

[Lambgirl 0]

In Mayfield, Ky. Jackson Purchase Medical Center does fills for one time $500.00 program fee then $125.00 for each fill thereafter. I am going to Mexico for my surgery then they will be doing my aftercare. I am self pay. Hope this helps. Lambgirl:)

[toml 0]

I had my surgery in March 2009. I was informed by the doctors office in Las Vegas that the insurance would only pay for the surgery and not for the fills. On average, fills are costing anywhere from $250-450/fill. It really depends on the insurance and how much they are willing to pay, if at all. I am pretty lucky that Dr. Teng's office was informative and was able to provide me with the information beforehand. Also, make sure the doctors offices uses the actual needles that made your lap band. Some doctors offices do not use the correct needles.

[jenhay 1]

Hi All, Just got an official letter from my insurance stating that they will cover 12 adjustments total, so I am SO HAPPY. It has been a long process. It has taken 5 months to get everything straightend out as to whether they will cover the fills or not. It took 7 full months from the time I first went to a dr. about the lap band to the date of my surgery. Go figure! Now I can make an appt. and get that long overdue fill. Thanks everyone for all the information and help. Jenhay.

[AngelaW 0]

I am glad I came across this thread. I just downloaded all of my "Explanation of Benefits" from my insurance.

It seems my doctor is billing the insurance under a surgery code for the amount of $1500.00 for fills and an additional $800.00 for the fluro.

In speaking to my insurance company, they informed me that because a fill is considered "invasive", they can bill it as an in-office surgery.

My co-pay is 20% as well. Of course the insurance is not paying the $1500 or $800 in full. They negotiate (as I am going to try to start doing).

If you have no insurance it is $150.00 flat.

Edited April 7, 2009 by AngelaW

[RestlessMonkey 7]

My co-pay is 20% as well. Of course the insurance is not paying the $1500 or $800 in full. They negotiate (as I am going to try to start doing).

If you have no insurance it is $150.00 flat.

Your co pay(the 20%) should be 20% of what INSURANCE pays, not what your doc bills. Say your doc bills $2000 and insurance pays $400. Your co pay is $80. If they are billing you more, then don't pay it.

[toml 0]

Doctors should not bill for fluoro. Fluoro is typically done in radiology as far as what I was told unless they have the fluoro machine.

[AngelaW 0]

We are required to have fluro now with every visit.

I understand the billing procedures. What sucks is how they changed the billing code to surgery instead of office visit. What use to be a $30.00 copay is now through the roof.

What gets me is how if you have no insurance, it's $150.00. If you have insurance, they bill the heck out of your insurance company and then, as in my case, you still end up paying MORE than the person with no insurance just to meet your copay. WTH??

sorry...whining I know.

Edited April 8, 2009 by AngelaW

[manykids 0]

Your insurance should be covering the fills at your copay amount since they approved of the surgery. You need to call the insurance company and find out if anything has been submitted to them. Of course the copay amount depends upon the type of insurance you have chosen. I Anthem and they pay 80% as long as it is with the same Doctor they approved the surgery with. Without insurance fills are very expensive. The total cost is $1500 without insurance with insurance I pay $80. Believe me your insurance will pay for the fills if they approved the surgery, as I work for an insurance carrier.