Has anyone been asked to pay a $4,000 "Program Fee" in addition to their Ins?

[michelleintheoc 0]

I've been approved for my band through my Insurance co. Empire Blue Cross / Blue Shield PPO. My surgery date is Dec. 9th. However I was told at my 2nd appointment that there is a $4,000 program fee for services that are not covered by my Ins. Co. Such as meetings with a Nutritionist and on-going support groups. Is this normal? I also inquired at another doctor's office in my area (Orange County, CA) and they told me in addition to my Insurance that they have a similar program fee, around $3,800.

It just sounds strange to me. Has anyone else heard of this? Or paying for this?

I will, as I feel I really like the program and the Doctor. But I just don't want to be taken advantage of either.

Thank you very much for any input!

Warm Regards,

Michelle

[untfluter 3]

My surgeon charges a program fee but it is only $500. I wound up being self pay when my insurance declined me and they include the program fee in the self pay price.... I am in south Florida area... $4k seems excessive...

I've been approved for my band through my Insurance co. Empire Blue Cross / Blue Shield PPO. My surgery date is Dec. 9th. However I was told at my 2nd appointment that there is a $4,000 program fee for services that are not covered by my Ins. Co. Such as meetings with a Nutritionist and on-going support groups. Is this normal? I also inquired at another doctor's office in my area (Orange County, CA) and they told me in addition to my Insurance that they have a similar program fee, around $3,800.

It just sounds strange to me. Has anyone else heard of this? Or paying for this?

I will, as I feel I really like the program and the Doctor. But I just don't want to be taken advantage of either.

Thank you very much for any input!

Warm Regards,

Michelle

[dragonflylover 0]

wow! no way, i never heard of this. granted i'm not a pro. I'm having my surgery in 2 weeks and haven't heard of any other charges outside of what ins will pay. could it have to do with your insurance? maybe they do not cover a portion? this doesn't sound right to me though. i would definately research more.

good luck!

[catfish87 3,471]

Hi. I have aetna INS. I had to pay a program fee of "only" $375 to my dr. I think you are being taken! My opinion. Good luck!

[Mimilou2004 13]

That is insane, can't you call a few more places even if you have to travel 30 minutes?

Mimi

[kcweir 0]

My doctor charged a $300 program fee that coverers the psych evaluation, nutritianist, support group meetings, etc. He is wonderful, I highly recommend him. My insurance paid for the rest of the surgery in full. His name is Dr. David Oliak. He has a very low complication rate and great staff. His main office just moved to Brea, but he still maintains his old office near Chapman Medical Center in Orange. I had my surgery at Chapman Medical Center, I can't say enough about how well they treated me. David Oliak, M.D. : Weight Loss Surgery in Orange County

Let us know what you decide to do.

[Lana24 10]

HI there,

I know your pain, two local docs in my area wanted to charge about that much. I had to find another doctor,as I could not afford it nor was I willing to pay it. I did pay 700 for a program fee, its basically giving money away. I never saw the nutricitionist after surgery nor have I gone to any of the meetings... basically I think its a "required" rip off that the insurance companies should not allow. But that is just my opinion.

[michelleintheoc 0]

Thank you, and I agree! I think it also covers my out of pocket surgery deductible. I read your story and I"m very happy for you! I will move ahead, because next year my insurance changes and I don't want to take any chances!

[Lana24 10]

Thank you, and I agree! I think it also covers my out of pocket surgery deductible. I read your story and I"m very happy for you! I will move ahead, because next year my insurance changes and I don't want to take any chances!

My fee did NOT cover anything like that. I still got seperate bills from hospital, surgeon and assistant surgeron. Please make sure you ask all of the right questions before you do it. Once its done, your in debt.

[mellabella78 0]

Wow, I would look for another Doc, that is A Lot!

[Moxi 0]

My program fee is $400 for nutritionist, psych consult etc. I think 4K is ridiculous.

[lilaz602 0]

The first doctor I saw wanted a $1000.00 program fee. I look around found maybe 2 out of 5 charge a fee the most I was quoted was $1500.00. I am going with True Results that doesn't charge a fee and everything covered by insurance. I would really check around before I paid a program fee. You can check on BBB and see if the doctor has any complaints, also there is a attached link to see if the doctor has any actions pending with the medical board. If your insurance is covering the LAP-BAND® surgery there is set prices that the doctor can charge. Some doctors are charging a program fee for a book and consultation with nutritionist. My insurance also cover the first doctor visit and all of True Results visits. I think if you decide to change your insurance will cover a new doctor. I think these fees are unnecessary, but that is my opinion. Good luck!

Edited November 10, 2009 by lilaz602

[1_QT_2H8 0]

Wow. That’s very steep! I paid a onetime fee of 250.00; everything else was covered by my insurance company Cigna. I was actually banded this morning at 6am. :tongue2: I would definitely look into another biriartic facility.

[GraciesMom 0]

Wowwie Kazowee, That is Lap Band loan sharking

Do do, do do (that is the the music sound of when the shark coming in the movie "Jaws") :tongue2:

Seriously, if you don't pay it, does the surgeon break your legs and not do the surgery???

That is absolutley crazy money, because you know they are pocketing that money too telling you that they are doing this, and doing that for you, when in fact, the insurance has already paid them a nice chunk of change.

Mine charged $300.00 and that covered the nutritionist, Vitamins, a great goodie bag with cool stuff, and the 3 1/2 hr pre surgical seminar. But $4000.00 just about pays the surgeons fee alone.

That is rediculous, find a different one.

[HappyHomeCC 2]

RUN.... look elsewhere. Check and see what your insurance covers, psych , nutritional, preop etc see what the surgeon charges each thing for and exactly how much. My insurance covered all that stuff i have to pay 10% of the actual surgery. my worst case senerio would only be 1500 out of pocket limit any how... since I have paided other money out on unrelated medical I have only $800 to pay out of pocket. for my whole lap band proceedure. and my fills are a 15 office copay. check and find out 4K is wicked high.