John Hopkins as Treatment Center - Out of Network Docs

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New Member

Date Joined Jul 2008
Total Posts : 5
   Posted 7/15/2008 10:04 AM (GMT -6)   
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.

James C.
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   Posted 7/15/2008 10:11 AM (GMT -6)   
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Regular Member

Date Joined Oct 2006
Total Posts : 27
   Posted 7/16/2008 6:35 AM (GMT -6)   


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. 


Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 7/16/2008 7:09 PM (GMT -6)   
Hi Odysseus.  I just posted a reply in the other topic related to Dr Walsh at Johns Hopkins.  Trust it will be helpful.  David

Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
Great wife and family who take very good care of me

New Member

Date Joined Jul 2008
Total Posts : 5
   Posted 7/17/2008 4:21 AM (GMT -6)   
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.

New Member

Date Joined Jul 2008
Total Posts : 5
   Posted 7/17/2008 4:42 AM (GMT -6)   
David, Webtao and CPA -

Thank you for your replies. I got a little confused in my previous response. David/CPA you are done and doing well, and coincidentally, Dr. Morgan in Richmond is the doc I will be going to see today. I did feel comfortable with him in the 1st visit too and he has some good numbers. My wife had a double mastectomy and reconstruction at St. Mary's in 2002 and it worked out well.

Webtao, thanks for the JH info and let me know how it turns out for you!
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