Are administrative fees a norm?

[sharon ann 0]

Hi : I'm new to this system, can't wait to see how it works. I've made the decision to have a lapband installed! I'm left with a few ??? Two unrelated ones are: has anyone with a hiatal hernia had the surgery; and do all Drs. charge admin fees in addition to what insurance pays? My Dr. wants $1200. in addition to the insurance I have. I don't understand why this couldn't be added into the surgery charge. Any thoughts? Thanks

Edited June 8, 2009 by sharon ann

[Sarah.R 2]

For the hernia question. There's heaps of people on here that have had that fixed while getting the lapband and I mean heaps. As for the admin charges, I'm not entirely sure about that. The fact that your insurance is paying I would have thought would be enough but the fact that he also wants money from you? Maybe it's just me but I find that weird. I never had to go through insurance so that could be why it doesn't seem right to me.

[maclynn 0]

I have never heard of admin fees in addition to the medical costs. Is your doctor associated with a Bariatric Surgery Center of Excellence? I would do some research on the doctors in your area before agreeing to those extra charges. I was only responsible for my co-payments and deductibles.

[RestlessMonkey 7]

I think you should probably find another doc. Most likely your insurance has contracted with him (or part of a network) to provide services for a set fee; I think the "admin fee" is his attempt to make a run around that and get more money. I don't know if it's illegal, but it isn't really, ummm...on the up and up?

Check around for different surgeons, or if he's the only one in your area, call and talk to your ins about it; get their take.

As to hernias, many of us have one of some type; some have them fixed before or during surgery, some wait. It's not usually a big deal.

[MissK 0]

and do all Drs. charge admin fees in addition to what insurance pays? My Dr. wants $1200. in addition to the insurance I have. I don't understand why this couldn't be added into the surgery charge. Any thoughts? Thanks

Hi Sharon

I'm not sure where you are, so I need to start this by stating that I am in Australia, so if you are not then it may be different.

For me, the standard scheduled fee for the surgery is AUD $12,000 which is all that my health insurance will cover. The surgeon I have selected charges $16,000 for the surgury leaving a $4,000 gap which I need to pay.

The reason MY surgeon charges the extra is that he undertakes NEVER to charge me for his professional services again, and accepts $4000 as his first and final payment for my ongoing care. This means that:

• he is very passionate about follow up consultations every 3 to 4 weeks in the first year following surgery and as is necessary on an ongoing basis - he will only charge our public health system (medicare) what they will cover and will charge them directly to ensure I am not out of pocket at any time.
  
  
• for each fill I have, he will again only charge what our public health system (medicare) will cover and he will charge them directly so that I am not out of pocket
  
  
• should I require any additional surgeries for rectify issues with the band, or have the bad removed due to an emergency, he will NOT charge me any professional fees (obviously there will still be hospital, anethetist fees, etc)
  

This gives me a great deal of comfort as I am young, single, battling to pay off a mortgage and make ends meet in general - so I know and he knows that financial circumstances can not and will not be able to impede my ongoing care.

It is worth asking the doctor why the other charges are in place, and also what charges you can expect to need to pay post-surgery for your ongoing care as this ongoing care is vital to your success.