John Hopkins as Treatment Center - Out of Network Docs

This continues the recent post about the famous Dr. Walsh but also throws it out there to all who have selected Johns Hopkins as the treatment center...

I am scheduled for RP on Aug 20 in Richmond VA but have an appt on Aug 8 at Johns Hopkins with Dr. Schaeffer for another opinion. I wanted to see Dr. Walsh but he does not take Blue Cross, so I have been trying to figure out the cost to me if he is MY MAN on this one (how much over reasonable & customary he is plus the out of network cost). Dr. Schaeffer and others there DO take BC/BS, and the hospital itself takes BC/BS. It has been difficult to get reliable information from them without an appointment with Dr. Walsh. It may be difficult to get reliable information even if I do see Dr. W, which could be the difference between $5,000 out of my pocket, or $25,000 or more. (There certainly is not that much in my pocket.)

How long did it take to get an appointment with Dr. W. and how long after that did it take to get the surgery on the schedule? I have T1c and gleason 6 so I do not think I am hurting myself if this takes a little longer to resolve, but my presurgical stuff for the Aug 20th RP is on Aug 5th, before I even go to JH for the appointment. I am torn whether to carry on as scheduled or wait and look into the JH route.

The other matter is selection of doctor if Dr. W 's out of network cost is prohibitive, since all I can find to look at is their JH website stuff,  their degrees, publications, awards, etc. but not their statistics/outcomes. HELP!

Thank You.

Odysseus,

I can't answer about Dr. Walsh, but I saw Dr. Partin at JHU and he doesn't take BC/BS either.  If the billing department can't help, perhaps Dr. Walsh's office staff can.  I called Partin's office and was told the cost of the office visit in advance and took a check with me.  BC/BS reimbursed me at the out of plan rate.   Dr. Partin's staff also told me what he charged for the surgery and that I would have to pay his fee in advance.  That was a year and a half ago and I'm doing the expectant management now so I'm sure the price has gone up.  Rather than mislead you about what Walsh may or may not charge, I won't talk price but do recommend that you check with his office to find out his basic fee.  Then call BC/BS to figure what you will owe. 

Boo 

Boo and David -

Thank you so much for the help. I called JH and set an appointment at the end of August with Dr. Walsh, so I cancelled my Aug 8th appointment with Dr. Schaeffer there. I am going to Richmond today as scheduled to consult my current doc in case the new plan does not work out.
They told me it could be November before Dr. Walsh can schedule the surgery. I have T1c and gleason 6 so I do not think I am hurting myself if this takes a little longer to resolve, but coincidentally, my wife has an appointment with her oncologist next week (she had breast cancer in 2002), and she will ask his opinion on waiting 3 more months for the RP.
The scheduler for Dr. W. said the visit would be $360.00 and the additional surgical cost about $3,000. Now I need to determine the out of network deductible I will have to meet, as well as the out of network coinsurance, plus this additional $3,000. But this will probably be manageable if around 10k and I believe worth the wait and complication. After reading your comment Boo, maybe $3,000 will be his total cost for the procedure! Guess I'll find out next month when I'm there.
Bon chance in August David. Be sure to let me know how it goes. Thanks to you both again.