Out of Network Facility Within the Same Building
I apologize if I am missing any information, but I will reply to any comments if anything needs clarification. I appreciate any help if possible. I would include some of the demographic info, but I feel like in conjunction with the rest of the post, it would probably be a little too identifying, so if any of that information is needed to help my issue I can reply to comments.
I recently had an ADHD evaluation at my university’s health center. This health center is in network as confirmed by calling my insurance company. I was given an estimate price of $475 and informed that they would NOT bill insurance and that the amount will be due at the time of service. No problem, I’ll just get the procedure codes involved and see if my insurance will cover them (they do) and file a claim to get reimbursed.
So the appointment comes, I pay, and I get a receipt. However, small problem, the receipt isn’t itemized. So I call and they give me an itemized receipt, but inform me that they don’t contract with any insurance companies so there is no way that they would be in network for me. Come to find out, the facility in which I received the evaluation is a separate entity from the health center.
The facility I thought I was being billed by, [PIA name] Health Center(in network), is a different entity than [Same PIA Name] Counseling Services (out of network). [Same PIA Name] Counseling Services is downstairs in the same building and I had no idea they were separate entities. The connection between the two is so strong, even the non-itemized receipt I received at the time of service literally said “[PIA name] Health Center” at the top. Now I am stuck with the bill for out of network service which is significantly higher.
Is there any protections in place for this or is there anything I can do? Am I just stuck with this bill?
Thanks in advance for any help!