Zoero,
Since you have a consult w/ him, you could discuss his fee schedule directly w/ him at that time. As I rethink it, it makes sense to approach him first since he’s probably the one who would make that decision. Be clear about your situation, cost of travel, lodging, cash paying, etc. so he can consider the expenses you have to lay out in addition to surgery. Besides his fees, there will be a fee for the anesthesiologist & the surgery center he uses so those will also add to the cost.
Well there is no proper etiquette and I would consider it a real game of negotiation and with some assertiveness. I would ask for the supervisor of the billing departments. Tell them you are shopping around for doctors and facilities which will motivate them to give you a better deal. I would then make a point (after getting those numbers) to ask if they have any financial aid assistance programs. In the US, normally (in bigger hospital settings) if you make below around $22,000K US per year, you fall into a lowest poverty bracket and can get a write off (this is after insurance is applied). Since you are coming from out of US, I don’t see why that wouldn’t apply to you if in outpatient hospital.
If surgery is at Silicon Valley Surgery Center, it may be hard to get financial assistance but if it is performed outpatient at hospital, you may get more help there. For anesthesia group, you need to ask the surgery center for their contact info as they bill separately.
Dr. Samji works under “Bass Medical Group”. If you look them up online, you can call the groups billing department and ask for financial aid policies. Sometimes they are posted online. Usually you just fill out a form and explain your financial situation and provide income documentation. You could talk to Dr. Samji directly about his fee but I would also speak to Bass Medical Group billing as well. He probably has the ability to override them but maybe the billing department might have other creative ways to help.
I had surgery in Dec and these were the negotiated rates with the insurance company that can be used as a guideline:
surgeon $6400
surgery center: $2000
Anesthesia: $1685
Misc labs/pathology: $200
pro-op appt: $200
Ok I will definitely do that. The cost is certainly a factor for me since I’ll be paying for flights and accommodation as well. Thanks again for helping me navigate through this. I’ll let you know how the consult goes.
Thank you so much Snapple2020! This is all very helpful! I’ll let you know how I get on.
Hey Snapple2020 - I knew you’d come through for us! Thanks for the great information!! 
Hi everyone, just thought I’d reply to my original post to avoid multiple threads.
I spoke with Dr Samji yesterday and was very impressed by his knowledge and genuine personality. I went ahead and booked surgery for my left side on September 20th! I still have to calling billing to negotiate price but he said total would be around $10k and there are 0% payment plans if needed so that’s great.
I’m wondering if anyone knows much about the area of San Jose and where to stay? I would like to stay as close to Los Gatos as possible and probably prefer an air bnb.
Hi Zoero,
Canadian here - I am thinking of going this route. How did the consult go? What were you able to negotiate for surgery fees? I will be paying out of pocket as well. Do you know if he does external and cut to base of skull?
bmcdiddie,
Dr. Samji did my surgeries. He does external & takes the styloids back as close to the skull base as possible. Just so there’s no confusion, that doesn’t always mean the styloids are completely gone. Sometimes the way the cranial nerves exit the skull impacts how closely the styloid can be cut back to the mastoid process so a bit needs to be left behind to prevent permanent nerve damage.
Thank you, will book consult today. Also looking to book with Dr Cognetti to get his input too. If they both think the styloids are too short (as the ENT here said) then I will delay surgery. If, however, they think surgery is indicated then I will be on a flight to get the procedure done. The slow speed and lack of attention to rare syndromes is what irks me about Ontario. I had a TOS surgery and it took 13 years since definitive diagnosis to get that done - despite having positive ultrasounds, CTs, emgs and clinical tests. Often surgeons here do patchwork procedures and leave patients scrambling. It is refreshing to see others call out Ontario healthcare - as it truly needs improvement.
Dr Cognetti does less surgeries than Dr Samji, so you’d have to wait longer for a surgery with him.
Hi @McDiddie - did you ever get the surgery?