Insurance Approval Question

I just got a letter in the mail from my insurance stating they approved my surgery and there's a date in there 1/25. I still haven't gotten a call from the doctor's office to schedule the surgery.

In the letter it stated that the approval was for out of network. I had no idea that Barix was out of network for me. When I first started the process I had asked them and they told me they were in network.

II am completely confused now. I've come so far in the process but don't want to pay out of Network rates. The deductible for out of Network is 5k and they cover 50% as opposed to in Network where the deductible is 1k and they cover 100%.

Has anyone got so far in the process and had to switch doctors? Any advice would be greatly appreciated.

First contact Barix and let them know that your insurance says they are out of network. My insurance told me my doctor was out of network. I helped my doctor's office set that straight because he was in network. If they are truly out of network that may have happened at the beginning of this year.

Hopefully it is something that can be easily straightened out. If not, I would find an in-network center and get the surgery done this year. Things often change Jan 1

I had a similar issue with dates and am also in Philadelphia. My surgeon had given me a date, but my approval letter came with a date further in the future. The surgeon's office was able to clear that up for me and the surgeons date was right.

Not sure about the out of network thing, you should call your insurer.

Call your insurance company to verify that your surgeon is out of network. If he is, ask them if this occurred due to the new year. If the surgeon is out of network ask your insurance carrier to refer you to other surgeons in network. Notice how I made surgeons plural. You want multiple referrals. A word to the wise, the insurance company makes the final determination about who is and who is not in network. If you call your surgeon and he says he is in network and your insurance carrier says no, you are the one who will get stuck with the bill not the surgeon. I went through something similar to this with another procedure and I'm on a payment plan.