The CRRS team feels strongly that getting help for endo pain and infertility shouldn’t cause crushing debt. At the same time, restorative surgery can take many hours of delicate and painstaking effort. Insurance reimbursement for this work is poor, because insurance companies don’t appreciate the value of an excision approach to endo as well as restorative surgery such as fallopian tube repair, c-section scar defect repair, etc.

Therefore, CRRS does not contract with any insurance companies, and we will not be filing out-of-network claims with your insurance. However, you may file a claim on your own and have the option to do this through Reimbursify at no cost to you. When scheduling surgery, it is always good to keep in mind the possibility of not getting any reimbursement from your insurance. If you believe that, without insurance reimbursement, you will not have sufficient funds for the surgeon’s fee, we strongly recommend against scheduling and proceeding with surgery.

Here’s how it works:

Surgery cost determination: The total cost of surgery involves two components: a “surgeon fee” and hospital charges (including anesthesia and pathology fees). Dr. Kongoasa operates at Northside Hospital, Atlanta, GA. Most of the time, the charges from Northside Hopsital are applied to your in-network benefits. You will know prior to surgery if the hospital or other consulting surgeons are out-of-network as well.

Out-of-Network: The CRRS is an out-of-network medical practice. This means we are not contracted with insurance companies to accept predetermined rates for services and surgeries. The amount you are reimbursed by your insurance will depend on your insurance plan’s out-of-network benefits, including your deductible and the plan’s “allowable amounts” for reimbursement. For patients who do not have out-of-network coverage or who would rather be a self-pay patient, we offer a self-pay rate for surgery. Regardless of your out-of-network coverage, we recommend all patients discuss financial options with our surgical coordinators.

Surgeon Fee: Our typical surgeon fee is between $2,000 and $10,000, determined before your surgery is scheduled. The amount is based on the expected length and complexity of the surgery as well as the procedures performed. We cap our fee at $10,000, regardless of how complex the surgery is. A $1000 deposit is required to hold your surgery date. The remaining balance of the surgeon fee is due four weeks prior to surgery.

Cancellations: If you cancel more than four weeks before surgery, the surgeon fee you paid will be refunded, less the $1000 deposit. If you cancel surgery within four weeks of your surgery’s date, we will refund 50% of the surgeon fee. If you reschedule, a $150 change fee is charged. However, we understand that life happens. Talk to us, and we’ll try to work something out.

Our approach to payment is unusual, but we think it’s fair. We strive to be transparent and to work with our patients regardless of their financial circumstances. So reach out to us and we’ll be glad to help.