Need Sage Advice

I've posted my story here elsewhere, but as is somewhat expected in my life, nothing is ever straight forward. Summary—mammogram —> tomosynthesis and US —-> stereotactic biopsy = DCIS, Estrogen and Progesterone +, HER2 -, NG 2-3.

I was referred to a general surgeon from a local suburban hospital. As we are in Pittsburgh, however, I chose to seek out a highly regarded breast surgeon. Background—Pittsburgh has two major health care providers, Highmark BCBS and UPMC (which is hospital and facility specific). I have Highmark. The only way you can cross networks is with a cancer diagnosis. The reasons for that are complicated, but basically, when the providers split (UPMC hospitals wanted to only accept UPMC insurance),the govenor of PA put in a stipulation regarding the cross network coverage, as most of the cancer resources at the time were centralized within the UPMC network. The stipulation gives patients until 2019 to cross networks with a cancer diagnosis, at which time the expectation is that the other hospitals not in the UPMC network will have had time to bulk up their resources.

So...I made the appointment out of network. Before even seeing me, they ordered a bilateral MRI w and w/o contrast, and I had to hand deliver my pathology slides and films. My actual appointment with the surgeon was scheduled for Oct. 23. With me so far? Here's where it gets complicated.

The preliminary MRI report comes back to my PCP. They wanted me to come in for the results, but I convinced the nurse to give them to me by phone. She told me there was lymph node involvement detected on the MRI. I fell apart, left work and headed for home. I asked my husband to go to my pcp office and grab a copy of the MRI report. By the time he got there, the final report had been faxed to them, so that's what I received. Not only was there no lymph node involvement (the final report called the cortex thickening 'likely reactive'), they also reviewed the pathology slides and downgraded my diagnosis to ADH. Fast forward through a long sleepless night to this morning. I took off work to try to sort through what's next.

At 9:20 am this morning, I received a phone call from the breast surgeon's office. As the diagnosis was downgraded, I can no longer see that surgeon without paying out of pocket. Basically, I was told I needed to go back in network, where the diagnosis is remaining DCIS. So...in network I have cancer, out of network I have ADH

WHAT NOW? Do I see a general surgeon who is going to have to choose between diagnoses? Do I seek a third opinion? I am so distraught over this nonsense that I am damn near dysfunctional. I just feel like I want this taken care of YESTERDAY, but every step forward is two steps back. I work in a stressful job that requires 100% concentration, something I just don't feel like I can give right now. What is wrong with me? This should be good news, the downgrade in the diagnosis, and I know this, but the doctors who believe that downgrade are beyond my financial grasp without insurance.

If you've made it this far, bless you. Any suggestions??