@Brandy, I was told that they may not have their insurance set up even by the time of my surgery so I’d have to pay out of pocket for Dr. Hepworth’s surgical fee which will range from $5K-$7.5K then they’d give me a superbill to bill my insurance for reimbursement. I was actually relieved to hear the cost would be so low as I was expecting some astronomical number then realized the hospital, anesthesiologist, etc. will be covered by my insurance. I do understand that if you see an out of network doctor, your insurance may not be willing to pay for the other charges I mentioned, thus I hope the insurance issues get sorted out prior to your surgery.
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Yes, thus my concern. I highly doubt they will have the time and resources available for me to help guide me through this. I can almost guarantee my surgery date will not hold.
So sorry that it’s caused a problem for you @Brandy , I hope that you can get it sorted and have a new surgery date soon 
@Brandy, Some months ago, @lilwider had to acquire a medical insurance advocate to help her fight her medical insurance denial of surgery w/ Dr. Costantino. In various discussions she shared her journey to appeal the denial in some detail. It took some months, but w/ the help of the advocate, her insurance overturned their denial, & she was able to have surgery w/ the doctor of her choice even though he was out of network. If you search @lilwider insurance appeal the links where she discusses her insurance appeal ordeal will come up. You can also PM her to ask for details if you think that would be helpful. Here are a couple of discussion links to get you started.
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If you have an out-of-network benefit that allows you to use it out of your state then his office doesn’t have to do anything. You pay his bill, they give you a superbill that you submit to your insurance for reimbursement. Of course you have to check to se if all the other people and places that will be involved are in or out of your network as well. My insurance company has something called an Access To Care form for when there isn’t anyone in network who can perform the treatment/surgery. The doctor’s office has to fill that one out. There is also something called a Gap Exception which is when you have to use an out of network doctor where the doctor agrees to accept the negotiated rate of your insurance company. I believe that is how Dr. Costantino’s office has been successful getting out of state insurance to pay. Again, that form would need to be filled out by the doctor’s office. Best of luck to you.
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Thanks @Chrickychricky for that info
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I’m here forl you if you need me
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Thanks for the tip about speaking with Lillian. I have chatted with her multiple times. My only issue is my insurance company (based in Connecticut) is not large enough where they have advocates for their clients. I had already asked months ago. Unless, she hired a private advocate to help…
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