Insanely Shocking!! - ThinnerTimes

Vszymczak · 05-14-2008, 05:51 AM

So in my search for gastric bypass surgery I have hit some bumps. My insurance wasn't willing to pay for it because it was an "exclusion" set forth by the business our insurance is held. I did check out Obesitylaw.com which somebody put up on this board. They were willing to take my case and thought they might be able to get my insurance to approve it. But they also wanted over $1,000 for their fees and they wouldn't even be acting as a my attorney. I chose not to go that route! My mom had offered to pay for the surgery, but when she found out it was going to cost $24,000 back pedaled faster than a serial killer riding a tricycle in a low speed chase with the FBI. "There are other options" she kept saying. I love it when people who aren't directly involved in this say there are other options when you feel like you've completely exhausted every idea held within your body. Luckily she's come around now that she sees I'm not trying to take the "easy" way out. I love it when they call it the easy way. As if you'd some how rather have your insides torn apart and put back together in a way God never intended them to fit, than to actually work for another 20 years with no progress or finishing results. In my quest to prove her wrong (this is an on going battle between us for many years) I shoved her foot in her mouth. Two weeks ago I started really working at losing weight. I've exercised every single day for two weeks for 45 mins and made it a point to jog for 15 mins a day. My starting weight 2 weeks ago, 279lbs. Now that's a lot of weight on my 5'2 frame. I like to think I carry at least 79lbs in my breasts but we all know that's unrealistic! In two weeks I'm now down to 262lbs. Amazingly, I'm still not carrying 62lbs in my breasts!

The most amazing part to my story, I've still been doing some research and looking for not only the best place for my surgery, but the cheapest as my mother is paying for it and she's as cheap as I am. I contacted one of the best hospitals in the area and they have a bariatric department so I met with some of the doctors and chose which one I liked the best. I got her pricing. $24,000 for cash patients but that also includes the hospital fees and everything that will need to take place in the first 3 months before during and after surgery. Then my insurance will pick up after those 3 months. The surgeon fees I thought were reasonable at $5,000. That being said I was still shopping around. Today I contacted a bariatric treatment center in my area. Obviously specializing in bariatric surgery. I got their fees as well. The surgeon fees for this place? Yeah I was shocked!!! It was only $1,400 for the surgeon fees. Do you suppose this is because this doctor works at a treatment center specializing in this surgery, or because he is wanting to help people and not looking to fatten his pockets with more money than even his 19 year old wife could spend in a lifetime?? I thought maybe this doctor just isn't as good as the more expensive one, as I'm sure most people would think. So I did some research and this is what I've found. The cheaper doctor has a better reputation and has also done 362 more surgeries more than the expensive doctor. Now there is also a big difference in the location of their two hospitals. One of them being in what most would consider the "ghetto" this is where the cheap doctor works at. The expensive doctor is in an upscale renowned hospital in the Dayton Ohio area. Despite the area the hospital is in, the "ghetto" hospital has an excellent review!! The upscale hospital has a great record also, but the pricing at that hospital is way more as well. go figure!!! I know I'm long winded and wordy in trying to get to my point, but here it is...I was insanely shocked when I found the pricing difference between the surgeon fees. Also the "ghetto" hospital, when they give you the cash pricing for all of the fees when having this surgery, if you know the right questions to ask, you can get the pricing that the insurance companies negotiate. The upscale hospital sits quietly on the line having NO idea what you're talking about. They didn't know that insurance companies get a lower pricing because they negotiate this. YEAH RIGHT! I have more research to do before I decide where to go, but I'm determined to finish getting all of my information by the end of the day today. This way I can start making a decision and get this thing going!!

fisher1000 · 05-14-2008, 07:56 AM

This is perhaps one of the most informative posts I've seen for self-pay patients. (We have quite a few of them on this board)

There is no greater tool than knowledge. The more you know, the more opportunities you have.

Your perseverance and your willingness to share your experiences are going to help a whole lot of people.

If there is anyone out there that deserves this, it's you. You are earning your seat on the loser's bench in a fantastic way! I hope things work out quickly, efficiently, and inexpensively for you!

Way to go!

-Mike

Jeanie · 05-14-2008, 08:20 AM

You know just be someone is more :up scale" than the other doesn't make them a better doc (as you found out). Sounds like you've done your research and that you are well on your way. I'm sure the next person that has to pay for this out of pocket will be thanking you for all the info you put on here.
Good luck to you in your journey for a better life. Keep us posted on your progress.

Godsblessedme · 05-14-2008, 09:04 AM

actually my recommendation is goto the board of medical examiners website in your state and do a query on the doctors names and you'll see if they have any malpractice cases or cases dismissed, or pending. Also ask them what the complication rate for their patients are. That makes a difference too. And let me just throw this out there because i too was at first a self pay until my insurance approved my appeal,.... you never know if you'll have complications or need the gallbladder out or if after 3 weeks (as i did) need to be re admitted for dehydration etc.. and insurance probably wont cover it because it'll be surgery related you have to think about those possible costs. The surgery could be 24k but if you had complications or needed a few extra days in hospital it could easily go upto 50K and then you'd be responsible for 50K not just 24. I'm just being realistic dear also make sure you realize you'll likely be spending about 100-300 $ monthly on vitamins, protein shakes etc... just make sure you think of all those things too. I'm wishing you well and as Mike said, KNOWLEDGE IS POWER

Tambo · 05-14-2008, 09:56 AM

I also was self pay. I decided on a Dr that everyone loved and had a good rate of success. It was 25k and I had no complications but even if I had to pay for complications, I would rather be in debt for a longer healthier life. Good Luck.

'thann · 05-14-2008, 10:41 AM

If the bariatric center you mentioned is Barix, definitely choose them. They deal in obesity surgery exclusively -- the hospital, including staff, supplies, etc., is geared toward dealing with obese people. That means larger beds, larger wheel chairs, larger gowns, larger chairs, larger blood pressure cuffs, larger everything. They're used to dealing with all of the little things that obese people live with every day. For example, they have helper sponges in the shower. Also, the kitchen is used to making the proper meals for you -- a good variety of clear liquids, not just the same vanilla Carnation Instant Breakfast meal after meal, as I heard one person say about her experience in a different hospital. Sounds insignificant, but it's a big deal in reality.

Good luck on your journey!

'thann