Help! Confused In Florida!! - ThinnerTimes

Native2u · 09-06-2007, 07:33 PM

I just returned from the seminar that my doctor held. Everything sounded really good and the fact that I have Aetna (PPO) was a bonus. I know that I have to tops, wait 6 months for surgery....but then again, maybe not. I have been dieting for over 20 yrs and my current General Doctor has a 5 year history on me...diets included.

Here is the question....They were going over fees and such and one of them really caught me by surprise.

Besides your out-of-pocket expense (co-pay only), did anyone have to pay an Misc. Admin fee??

They said..and after the meeting I asked again, just to make sure I heard it right, that not only do I pay my co-pay, but that I would also have to pay an Admin fee of $3700.00. I would think that would be included with the whole bill that they (Dr) sends to the Insurance Co.

What do you think???? My husband thinks that I should be calling around and asking other Dr's if they have any "hidden" fees.

Cinerbelle · 09-06-2007, 08:24 PM

I would look into as many surgeons in your area that does the surgery and go with the one that has the most experience and that you feel comfortable with. I have never heard of the "admin" fee. I only had to pay $20 co-pay to for my pre-op tests...but I have Aetna HMO.

Robin W · 09-06-2007, 08:32 PM

Yes, I had to pay a fee also because of having PPO insurance. Not even 1/2 of what you're paying, but more than I really wanted to pay. I always thought having a PPO was a good thing. I guess it's not if you're on the receiving end (dr). Good luck to you.

Native2u · 09-07-2007, 06:24 AM

UPDATE.....I read my Insurance card last night and I had it in my brain that we had PPO......we DON'T, we have HMO. I know that will make a huge difference. I do remember at the seminar last night, the insurance person saying that they don't take HMO......but they do take PPO.

I'm not too sure about the Admin fee thing. My husband is stressing to me to find another doctor.

Also, where we live, our County is very large and he only has 1~nutritionist and 1~psychologist that he wants you to go to. Both of these people are over 1 hour away. It doesn't matter that I own my own business and that I'm the only employee or that I work Mon-Sat 10am-6pm. I talked to the Dr last night and he basically said....if you want the surgery, you will have to find time. I was just a little taken back, at that point. I'm thinking...I need to make money to pay you.

What do you guys think? Am I being too hard?

Duckie · 09-07-2007, 08:11 PM

wow! Mine was only $350. Good luck.

Deirdrea · 09-07-2007, 09:31 PM

I"m in Kansas and I know that every clinic is different, but I had probably about $1500 in fees. I had 8 classes pre op that were out of pocket and then $750 for lifetime post op classes. I think $3700 is high and I would definitely be calling around if you can and find another doctor/clinic if you can.

Good luck

Haveaball · 09-08-2007, 04:51 AM

Yes I had to pay an out of pocket fee, I think it was $600. I honestly would have paid any amount. Good luck to you.

Jeri · 09-08-2007, 06:45 AM

I don't know what that admin fee is but it sounds to me like this dr has worked out a way to get more $$ out of his patients since we know insurance only pays a portion of what they are billed.
I have a $700 deductible & then will have to pay 10% so I'm figuring about $4000 give or take a few hundred. HOWEVER if I were told that was an admin fee I would be looking elsewhere.

Native2u · 09-08-2007, 09:26 AM

Thanks for all the responses I've gotten!!!! On Monday, I'm going to call them and ask for a "break down" of the $3700 admin fee....and what it covers. I'll post it, when I get it.

FYI: according the Insurance person on Thursday night, in addition to the $3700 fee, I will also have my "out of pocket/co-pay" fees. It just doesn't sound right to me right now.

I was thinking that the cost was high too. Thanks for reconfirming what I was feeling.

Zenomia · 09-08-2007, 09:41 AM

I had to pay out of pocket fee/max family hospitalization fees, and upfront any fee's NOT covered by insurance...such as the dietition. Some policies won't cover the dietition or the psychologist profile, which are required for most Surgeons. If your Surgeon is being that difficult, look elsewhere. This is not like buying a car, or a house...this is your LIFE we are talking about. You wouldn't put your LIFE into the hands of someone who refuses to work with your schedule, or can't offer you sufficient care years down the road. You need to find someone that can not only do an exemplary job NOW...but will be there 1-5 years later just in case. By only allowing certain reports from certain people, that only means he's getting kick-backs from those professionals. Most surgeons will allow you to see whomever you wish...as long as you get the reports to them. Most have their preference on who they would like you to use....but ask why. Some dietitions that people are given have NO clue as to what it takes for a bariatric patient. There are so many variables out there. My first advice....find someone who knows what the heck they are doing, has a proven track record, a Certified Program...Your insurance will know which Drs. are certified in Bariatrics...(means they have had additional specialized training in the field...not just a General surgeon who hopped on the big buck band wagon.) Just remember, your not just looking for some shmuck to preform your surgery....Your looking for the Surgeon who can make or break your life....don't take that lightly. SHOP AROUND!