Can someone explain like I am 5 what is going on here and offer any solutions?

I am having a procedure done in 2 weeks. This procedure is gender-affirming care and I originally was going to bite the bullet and pay out of pocket for this procedure. My mom got new insurance and they said they cover all of it even though it is out of network except for $10,000 which is my out-of-pocket cost.

I got all my letters submitted in support of surgery, got a prior authorization completed, all that jazz.

Now the provider wants payment upfront which I feel I should not have to do. They said I needed to because the insurance won't provide a letter of agreement. My insurance has told me they already provided a letter of agreement.

The surgeons office is saying since there is a shortfall that it falls on me and that I am responsible for paying it. Which I don't understand.

Can anyone give me any advice? I feel I am getting a runaround and getting screwed over by both my provider and my insurance.

submitted by /u/Standardtrans
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