Help me understand network gap exception

I am trying to understand how network gap exception works. The rules are very unclear and everyone I ask gives a different answer. Gap exception was approved to cover out-of-network provider as in-network. In network benefits are $15 copay, annual deductible does not apply. Insurance is paying 100% of the allowed amount. Of course this doesn’t come anywhere near the billed charges. The provider is not happy with the reimbursement and is appealing the amount. In the meantime, there is a patient responsibility on each claim that equals the non-covered amount. Since the provider is covered under the gap exception, shouldn’t there only be the co-pay? Or if OOP max met, $0 patient responsibility? Under a gap, isn’t the out-of-network provider agreeing to accept the allowed amount as their payment and not bill the patient? In Florida if that makes a difference. Thank you in advance for any clarity you can offer!

submitted by /u/Unusual_Angle3215
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