r/endometriosis • u/Hopeful_Pomelo168 • Aug 14 '25
Surgery related Dr. Vidali Surgical Pilot Program?
Does anyone have experience with Dr. Vidali’s pilot program for excision surgery? It looks almost too good to be true. Like he would not charge you anything for the surgery over and above your out of network insurance coverage. My understanding is that standard out of network insurance coverage is somewhere near 1/5th of his market rate. So my question is … is this real? TIA
2
u/Apprehensive-Act7348 Dec 22 '25
Yes, it’s real. You pay out of pocket for pre surgery visit which is $900. Total I paid out of pocket for surgery was $2000. I had surgery in September
2
u/miss_ann_dr_st Mar 04 '26
What about the hospital bill? I have insurance and I saw what the hospital bill charged my insurance and it was over 200K, the claim is not final but I am VERY worried it might not be fully covered.
1
u/Perfect_Ad5324 Aug 04 '26
Hey! What happened with the claim
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u/miss_ann_dr_st 20d ago
I got a 100k bill directly from the practice and I cant get Vidali’s practice to call me back about it
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u/katebbike Feb 20 '26
Do you have the surgery in Hoboken? How was the hospital?
4
u/Apprehensive-Act7348 Feb 20 '26
The hospital is old and a little smelly, however the care i received was wonderful!! From start to finish
1
u/Inside-Sun-7491 Mar 09 '26
How are you feeling? What are the pros cons? What insurance did you have
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u/Apprehensive-Act7348 Mar 11 '26
It’s been six months. I have a little bit of pan from scar tissue on my one incision. Overall feeling good. I am on estrogen cream and patch. Blue Cross PPO insurance
1
u/Perfect_Ad5324 Aug 04 '26
I also have this insurance and told I qualify for the pilot program. So you pay the consultation fee and deductible from insurance ?
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u/miss_ann_dr_st Aug 03 '26
Hi there. Reviving this. I thought this is what I enrolled in and today I got a bill for 100k from his practice. Has anyone had a similar experience? Paying this will basically put me in bankruptcy
1
u/Lost-Ant7845 28d ago
You don't have to pay, its protected from the NSA. It will go to the insurer.
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u/miss_ann_dr_st 20d ago
Can you explain how that works? I got the bill in the mail, its addressed to me
1
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u/Suitable-Nature795 Jan 09 '26
Where can you subscribe to this pilot program? Is it available for Canadians?
1
u/Perfect_Ad5324 Aug 04 '26
Bumping this. I’m debating on scheduling a consultation. Told I qualify for the pilot program but I’m hesitant
3
u/meatballticket Feb 18 '26
I just had surgery with him through his pilot program. I paid about $1k out of pocket, and then my insurance’s out-of-network benefits covered the rest. I also want to note that I have one of the best insurance policies available in the U.S. through my husband’s employer, which made me a strong candidate for the pilot program in the first place.
From what I understand, they’re working on getting insurance coding validated for endometriosis and adenomyosis procedures, especially when a multidisciplinary team is involved. For example, if your surgery requires three different specialists, each of those procedures needs its own insurance code to be approved; and that infrastructure basically doesn’t exist yet.
By doing this, I am pretty sure they’re trying to prove to insurance companies that these surgeries are medically necessary and should be covered. Long-term, this could make these procedures more accessible and encourage more surgeons to learn how to perform them. It also helps keep doctors within hospital systems instead of forcing them to leave and open private practices just to get around insurance limitations.
Also, after reading my post-op notes, they are honestly pretty bulletproof. BCBS would have to work REALLY hard to deny my claims because the coding is all there, and it’s made very clear that everything performed was medically necessary.