Saturday, February 13, 2010

One step forward.......50 steps back.

I think the positivity is out the window at this point. My sister and her boyfriend were coming over to watch the kids at 9 so DH and I could go to the seminar. At 9:05 my sister texted to say that the BF had locked his keys in the trunk. ARE YOU KIDDING ME???

Ok, plan B. Take the kids to sisters apt. which fortunately is close to the seminar. At this point I'm feeling better. Annoyed but better. The seminar begins, great info-as expected I knew a lot of it. But I do think that it was helpful for the DH. Surgeon leaves; bring on the case manager. I think I'm in the all clear because I have insurance. All of the sudden she says "and your first visit to Dr. D is $525 it is not covered by insurance."

WHAT? Did I just hear correctly? I did not see this on the website. In the 500 calls I made to the office no one mentioned this. $525.00?? $FIVE HUNDRED AND TWENTY FIVE DOLLARS?

This puts a serious monkey in the mix. The kids birthdays are this month and next month and we planned to buy disney tickets which takes almost all of our extra money for a little while. I don't know when/if we will be able to pull it off. The money covers their administrative time, a dietician visit and the surgeons time. I'm very frustrated. I know that I can still pursue this process it will just take longer, but I'm really feeling down. I realize that I'm lucky insurance covers it at all.....but the money of course is due at your first visit. I just wasn't expecting this. It was a real disappointment. Other people were surprised too, which made me feel like at least I wasn't alone. My sister joked and said I should host a fundraiser! Maybe I should sell some of my cards (I'm a Stampin' Up! demo).

I just need some time to digest this. Thanks for letting me vent.

9 comments:

  1. I hate those program fees. The first place I went to had it and I couldn't afford it- plain and simple. The thing is they say it covers nutrition and psych eval and all that, but the hospital I ended up going to had no fee, plus the nutrition appointment and psych eval was just covered with $15 insurance copays (a lot less than $500 dollars). I had several hospitals in the area to chose from, but I will say if I didn't I would have paid it because it's been worth it. Good luck with your decision.

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  2. Thanks Linda! DH and I have some stuff to discuss, its not off the table completely but it does make it a little more difficult. I know what I want in the end, so I'm just a little bummed.

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  3. Are there any other hospitals or surgeons in the area? Not all places charge fees like that - and some charge more. I did not have to pay a thing. It's all been covered by insurance and aside from my insurance changing, all the prices have at least still been negotiated by my insurance company, even if I have to pay them. To be honest, I wouldn't pay it. I would do as I have read in other blogs and I might actually drive a little further. To me, charging this fee means they are in this for the wrong reason. Not that there is anything like perfection and fairness in our world...but I can be picky, in cases like this, about what I'm going to tolerate. Yes, it's a business...but at the end of the day...the customer has to be happy. And to be honest, it makes no sense to say that your insurance company won't cover a nutritionist. This means your insurance company won't cover their nutritionist...but you can find others. Anyway...sorry, I'll get off my soapbox. Just check into options, that's what I'd say.

    And don't let this get you down. Maybe this will lead to better things!

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  4. I also didn't have to pay anything more than my normal insurance co-pays. My insurance covers several dietition visits free, but I had to pay 20% and part of my deductible (which I think came to 150) of the psyhc visit and $20 dollars for a office call when I met the surgeon. Unless your insurance doesn't cover the dietition and physc visit at all I would look into another office. However, I would double check your insurance. It may be that you aren't covered for those two things (I know some don't), or that you have a 500 dollar deductible that applies only to certain types of visits that hasn't yet been covered.

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  5. thanks guys. They said that the reason its not under insurance is because their dietitian is out of network. I was going to ask if I can see another dietitian, but it may just be easier/faster in the long run to use theirs. I really wanted to have this done in April, because I have a business trip in May.

    I'm just starting a pity party.....don't pay attention to the whining. :)

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  6. Hey, don't apologize for venting...we're here to support each other and that means the ups and the downs! One of the three places I went to also had a program fee (I didn't pick them).

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  7. Don't worry about having a pity party. Sometimes it's what we have to do to get back to the positive and like BG said, we are all here for you to pat you on the back when you do well and help you out when it feels like it sucks. Believe me, if you read my blog...you'll see lots of pity parties! :)

    Another dietician that you choose won't necessarily mean you can't do this in April. It might even mean it gets done faster. No telling on that one. I completely understand about the easier/faster dynamic...I'm good about generally taking that route. :) But in this case...I really think I'd have a problem with this. My clinic knows that some of their preferred associations are not my best option and while they recommend so-and-so they also always tell me to find my own in-network providers if it's something they don't do in office. That has saved me quite a lot at this point. At least $700 that I can just remember in my head. I had my psych consult done faster by going through my own than by going through the recommendation. It will all work out, that's for sure!

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  8. What a crock! Like the others who commented, I didn't have to pay an up front fee. I have a $150 deductible which I had to pay and that was it. What the heck is an in network surgeon doing having an out of network dietician? Doesn't make any sense. I really hope you can find another place because it doesn't sound right to me. I'm sorry you have to go through this. Don't feel bad about venting. Totally understandable.

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  9. I definitely understand your frustration with this. You could shop around...program fees vary by surgeon and some don't have them at all. Mine charges $1000 but it's not due until 5th month of my 6th month supervised diet. I had to tap into my 401k for it but I think it's worth it. What's the point of a retirement fund if I die from obesity before I can use it. Try to remember it's merely an obstacle, a postponement, but if you reall want it, you can make it happen. Good luck!

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