Thank you for the info.
I believe House Clinic providers are not employees of the same system as St. Vincent providers, formerly Daughters of Charity California, a financially troubled hospital and recently purchased by Verity -- although their nurse-to-patient ratio and safety scores that I found have always been great. I see this independence as a tremendous benefit to us as patients, and hopefully to the providers as well, just don't need more conflicts of interest. My husband and I are retired, no employer insurance, but I have taken advantage of a Health Savings account (the stealth retirement account if you don't burn through it). How much these services cost is still almost always a surprise in the United States, and having to meet an in-network max AND an out-of-network max is the kicker I am trying to reconcile. It would make sense to offer just a few care centers for people with serious AND rare health problems, less pressure and less tempting for providers to say "I can do that" when they just don't have the experience or the team to do it.
I will call billing people again for suggestions for my hearing on the 11th. One advocate emphasized using what the doctors say, and giving written instruction when admitted to the hospital as far as in-network providers. This just doesn't work with rare, serious problems and emergencies. God chose our generation to live through this. I'm hoping to work with others to manage it, so glad this forum exists.
Just an update--everything is paid now (made my out of pocket max) and my appeal was successful. Rita in the insurance dept. at House was VERY knowledgeable and helpful, and she loves what she does, how rare is that. Pay attention to what your docs say, it will be what you need in an appeal.