scheduled fee???

Ok, so my PHI doesnt cover the sleeve, im getting back a tiny amount from medicare for my aneathetist fee and nothing for my hospital stay ($750 a night mind you!!) because they dont cover my surgery... which i think is wrong as they should still cover my stay but anyhoo i knew this going into it! When i rang MBF to see if i get anything at all back from the surgeon/theatre costs they said something about a scheduled fee?? Anyone know what this is?? I didnt quite understand the persons jargon. Anyone who hasnt been covered by their PHI know what this means at all? ta!

Ive got MBF as well and they assure me they will cover my surgury (as Ive rang to verify it several times). The are covering my hospital and some of my anethasist costs. The schedualed fee is the fee that medicare decides the surgery is worth, however, doctors being doctors like to charge through the ass, and as a result, you will most likely have an out of pocket fee (mine is 5,500) which is NOT covered by medicare or private health insurance. You can get special codes from your surgeons office, and then use these codes to find out what the schedualed fee is and how much your required to pay. Hope this helps, am happy to answer any more questions if you have any. Good luck :)

ya my particular cover with MBF doesnt include the sleeve - i should have stated that properly - not MBF as a whole! :) which still doesnt make sense to me, as if my policy doesnt cover the surgery (which i know for certain), why would i then get anything back from them? Thats why im confused! :)

hmm im confused too... if you arent covered then you arent covered... hey there are some phi places that wavver the 1 year wait period, perhaps u shpuld look into them? not sure which ones, but its worth a try? stupid MBF, they are straight out the door as soon as this sleeving business is over, they dont seem to pay very much at all!!! Medibank Private seems to be the one to go for..

lol i was sleeved 2 weeks ago, so bit too late hehe!



thats why im confused, i reminded the guy at MBF this morn on the phone that my particular policy doesnt cover the sleeve and thats when he started going on about scheduled fee's and that i wouldnt get anything back on the hospital stay but will on the surgeons fee's and thats when i started thinking, what the hell is he talkinng about!