Billing claims PT is out of network but website says in network

My PT I selected from a list of in network providers and vitisted him twice, once for the initial assessment and another visit for further therapy. We booked out 12 visits per the Ortho’s recommendation but when I saw the insurance claimed the PT was out of network making me responsible for 100% of the bill when the health insurance website shows the PT as in network which I would only have to cover 5% of the bill since I have met the deductible. I have asked the insurance company to review and in the meantime I have canceled all further PT visits.

This is the 3rd PT I have had to visit. First one was in October 2021 and after 2 visits they refused to see me because of their issues with processing insurance claims. By the time they figured out my insurance it was 2022 and my insurance had changed from Aetna to United Healthcare which made them out of network.

Second PT I started seeing in 2022 but after half the year they claimed the insurance didn’t pay them enough and would stop accepting United Healthcare.

Now I am onto my 3rd therapist.

US healthcare sucks, I have a GEHA HDHP plan and I was wondering if there are any ways to escalate the issues I am having. You would think that the health insurance would want to see me get the PT I need to prevent further injury. I have spoken with their customer care specialists and each of them don’t bat an eye to the issues I am having.

I reached out to my local hr and they didn’t have any advice for me.

See also  Prescription from doctor not covered by insurance