$1850 ...Did any of you pay a fee? - ThinnerTimes

Blaqfyah · 02-02-2007, 08:59 PM

So I got my surgery date...2/20/07. But one issue I'm having is the $1850 clinic fee that I have to pay. I know that I want the surgery but I can't get over how much I have to come out pocket. I have to pay $350 for a psychological evaluation...because I they won't except one from a Psychologist contracted with my insurance (Blue Cross Blue Shield Federal PPO). The same insurance company that's going to pay for the procedure. The other $1500 is in a clinic fee. But I'm not really sure what thats for. I really don't go there and don't particiapte in any activities. I do plan on going to the groups but they are in the middle of my work day.

My doctor is suppose to be awesome and his clinic is a "Center of Excellence" but so is the hospital that I am have the surgery at. I am now looking into just switching to an equally excellent doctor at the hospital. I don't think he has an fees...at least not this steep.

Please let me know what you are thinking.

I will say I was aware of the fees at the beginning of the process. And that is why i set up a flexible spending account. I've put away the money to cover the fees. The only problem is, I still have to pay them out of pocket first and then get reinbursed for it later (about 3 days later). But HELLO I don't have the money to pay in advance to be reinburse. It is a very cruel circle. So If I don't come up with $1850 with in 2 1/2 weeks then I won't be able to have the surgery .

Sorry for the long post.

So has anyone else had to pay fees for the surgery.

JenBear7 · 02-02-2007, 09:02 PM

Havent had the surgery yet, but my out of pocket will be: $50.00 Processing fee.. (DONE).. $15 every visit to the doctor.. and $100.00 for the surgery/hospital stay.. no cost for any tests, and its a straight 100 bucks for the hospital .. if there are complications.. its 100 per visit.. but no, nothing that steep.. (altho, really.. I'd sell my soul if I had a date and they told me I had to come up with 1500 more... especially if its something you are going to get reimbursed for.. your Flex spending isnt just a credit card? )

MiladyB · 02-02-2007, 09:04 PM

I had to pay a total of $80 for the initial appointments with the Surgeon, Behaviorist and Internist. I had to come up with $298 for the Bariatric food product my surgeon has us on 2 weeks pre-op and 2 weeks post-op and then it was $1000 for the surgeon doing the surgery. I didn't pay anything for the hospital or the subsequent follow-up appointments. It was a lot of money but NOTHING like the cost would have been without insurance. Hope you can get things worked out.

Barb1024 · 02-02-2007, 09:09 PM

I had to pay $12,000 to my surgeon, $15,000 for the hospital,,,$850 to the anthesiologist,,,,and all costs of psych eval, nutrionialist, blood work, etc....unfortunately, my insurance did not cover the surgery so it was all out of pocket for me...I had to refinance my house to have this done but I am not complaining one bit...it was so worth it. I had to think of it this way,,,"some people buy new cars that cost $40,000 or more and they only last a few years,,my surgery cost less than that and will last me a life time" Money doesn't compare to our health! Whatever you decide I wish you the best....Good luck!

Duckie · 02-02-2007, 09:12 PM

I had to pay $350 for the nutrionist and exercise classes. It had to be paid before they'd set you up with any appointments. Other than that it was just $10-15 copays for MD visits. Nothing for the actual surgery.

JenBear7 · 02-02-2007, 09:15 PM

Quote:

Originally Posted by Barb1024

I had to pay $12,000 to my surgeon, $15,000 for the hospital,,,$850 to the anthesiologist,,,,and all costs of psych eval, nutrionialist, blood work, etc....unfortunately, my insurance did not cover the surgery so it was all out of pocket for me...I had to refinance my house to have this done but I am not complaining one bit...it was so worth it. I had to think of it this way,,,"some people buy new cars that cost $40,000 or more and they only last a few years,,my surgery cost less than that and will last me a life time" Money doesn't compare to our health! Whatever you decide I wish you the best....Good luck!

Cost of your happiness / health.... Priceless

Duckie · 02-02-2007, 09:17 PM

I agree. It's priceless. Oh, and I was told tonight that I am "smokin'" hot. lol THAT would be worth the damn $40k ALL BY ITSELF.

JenBear7 · 02-02-2007, 09:18 PM

Quote:

Originally Posted by Duckie

I agree. It's priceless. Oh, and I was told tonight that I am "smokin'" hot. lol THAT would be worth the damn $40k ALL BY ITSELF.

WooWoo.. Smokin!!! *giggles* Again... Priceless...

Blueyz · 02-02-2007, 09:29 PM

Quote:

Originally Posted by Blaqfyah

So I got my surgery date...2/20/07. But one issue I'm having is the $1850 clinic fee that I have to pay. I know that I want the surgery but I can't get over how much I have to come out pocket. I have to pay $350 for a psychological evaluation...because I they won't except one from a Psychologist contracted with my insurance (Blue Cross Blue Shield Federal PPO). The same insurance company that's going to pay for the procedure. The other $1500 is in a clinic fee. But I'm not really sure what thats for. I really don't go there and don't particiapte in any activities. I do plan on going to the groups but they are in the middle of my work day.

My doctor is suppose to be awesome and his clinic is a "Center of Excellence" but so is the hospital that I am have the surgery at. I am now looking into just switching to an equally excellent doctor at the hospital. I don't think he has an fees...at least not this steep.

Please let me know what you are thinking.

I will say I was aware of the fees at the beginning of the process. And that is why i set up a flexible spending account. I've put away the money to cover the fees. The only problem is, I still have to pay them out of pocket first and then get reinbursed for it later (about 3 days later). But HELLO I don't have the money to pay in advance to be reinburse. It is a very cruel circle. So If I don't come up with $1850 with in 2 1/2 weeks then I won't be able to have the surgery .

Sorry for the long post.

So has anyone else had to pay fees for the surgery.

$1500.00 copay
$$275 or so for psych consult
$40 copays for dr visits
$20+ each time for RX
Other fees.

The feeling of being thin+PRICELESS.

It is worth every penny. I was ready to pay and finance the surgery if I couldn't get my denial overturned. I looked at it this way...I would buy a car, so why not buy something permanent that will change my quality of life. Worth every penny and complication and debt that I have obtained.

Squishy · 02-02-2007, 10:25 PM

I apologize, because this is going to be long, but I hope it helps.

First, the company for which you work undoubtedly has an insurance representative in the Human Resources department. Go and explain your situation to that person and ask if there is anything he or she can do to help. Usually, you have to submit the bill and then they release the payment. It is unusual for you to have to pay it first. You may have been mis-informed and the insurance person could clear it up for you. If that is the rule, maybe they could get it waved under the circumstances. Maybe your employer would give you a payroll advance with a simple written agreement that you would pay it back as soon as your reimbursement arrived. They may be willing to do this since they can take it out of your pay if you don't pay. Their risk is pretty low.

If that doesn't work, try this...

If you meet with the clinic accountant/payment person and showed them the balance in your flex spending account, and explain the reimbursement process, would they allow you to make small payments you can afford. You could make the first payment out of your pocket, submit it and then use the reimbursement money to make the next payment, submit it for reimbursement, etc. until it is paid off? I bet they would.

Explain that you were responsible and planned ahead by depositing money in your flexible spending account, but that you have learned that you can only receive the money as reimbursement for payments and that you just cannot afford to pay it all at once, even though you have the full amount in your flex spending account. (Show them the statement)

Explain that you have gone through all of the preparation and pre-testing for the surgery for the past X months and that if you cannot work out a payment plan, that you will have to cancel the surgery and begin the process again. Further explain that if you have to start over, you will have wasted the money you save to pay for the process.

Most hospitals and clinics make payment arrangements with people all the time, so if you demonstrate that you have the money, I'm guessing that they would work it out with you.

If the first person you talk to says "no", don't argue with him or her. You want him or her to help you and challenging them or making them angry won't help you get what you want. Say "I understand that you have to work within the guidelines that you are given, but I'm sure you can empathisize with my situation." Then very politely ask if there is a department head or someone to whom you could talk to see if he or she might have the ability to make a special arrangement.

If they get a manager, explain that the first person you talked to has been very nice and was trying to help, but could not make an arrangement with you.

Tell the manager what you explained to the first person, explain that you know that this is not their normal process, and ask if there is any way that he or she could help you. If they cannot do a payment plan, ask if they had a speaker phone and if they would get on a call with you to Blue Cross to see if there is any documentation that the clinic could provide that would enable them to release the payment. It could even be sent directly to the clinic if they are worried that you would not bring it in.

C'mon...you can do this! Start with your employer's insurance manager on Monday! Let me know what you find out.

-Mike-