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Dr. Charging a program fee



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Is it common for lap band doctors to charge a program fee? My doctor doesn't submit anything to the insurance for approval until fee is pay upfront. I am a little nervous if the insurance doesn't approve the surgery I will lose have a portion of my money.

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I think it is common to charge a program fee, but I don't think it's common to charge it BEFORE they've submitted to insurance. I didn't have to pay mine until after I was approved and my surgery was scheduled. I paid it at my last pre-op visit with the surgeon...I would be skeptical if they ask for it prior to approval - seems odd.

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My surgeon required a program fee before surgery. It was $500 total, and I had to pay half after my consult and before I moved on to my other appointments. The other half was due after I had insurance approval and before they would book my surgery. Also, since I had a 3 month medically managed weight loss program, I had to pay $75 before I started that. All of these fees cover things that insurance doesn't cover, such as appts with the dietitican, exercise physiologist, and mental health worker. I didn't mind paying the fee, it was comforting for me to know that the program is so holistic. Obesity is not just an eatting problem, and to really have successuful long term weight loss, you have to be able to attack it from all aspects!

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How much is the fee? My Dr. did not charge one and I don't know of any in Richmond that do. I think it is a way to pad their pocket. If there are other Dr's in the area I would shop around. To me I could see a couple hundered dollars if and only if it includes nutritional counseling.

Greg

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When I first looked into Lapband surgery, I called a practice in NY that was listed as a Center of Excellence. They required a $1000 nonrefundable fee, $50 of which had to be paid before they would even book an appointment. I called my insurance and asked about that. Anthem Bc/Bs said practices are not supposed to do that and that it was somewhat shady. I called the doctors office back and asked more about it, and they told me it was for the hassle of dealing with insurance companies. This just didn't sit right with me, so I called another practice and talked to them.. made my appointment with them, and they've been wonderful. I would definitely shop around. The doctors are paid well by insurance companies, there is no reason they need to add extra fees.

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My surgery center has an $800 program fee due at the pre-op appointment. They stressed that only patients who actually have the surgery pay the fee. The stress on this statement lead me to believe that that's not always the case in some centers.

Take advantage of shopping around if you have the luxury.

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There have been other threads of this nature in the past. Not all surgeons charge a program fee. Be very careful of paying a fee up front and find out what you get for this fee.

My surgeon DID NOT charge a program fee.

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