NEED ADVICE Large therapist network told me for months that I was seeing an in network therapist, but charged me as if therapist was out of network. Is there any approach to make them honor an in network co-pay.

I am in a tough health insurance spot. I am hoping this is the right audience to get some advice, but I’m also open to hearing where this might fit better.

Late 2022 I wanted to restart attending therapy. I had just moved and changed insurance, so I first tried to find a suitable local practice. However, I struggled to find any local practice that was accepting new patients. So, I turned to a company that operated as a large network of affiliated therapists. On the first enrollment call I had with them in January 2023 I provided my insurance network name and policy number. The person on the line took the info and created an appointed for me the next week with a therapist he told me was in network for my insurance. For a month all was well. I liked the therapist and was having weekly sessions with her.

Then almost exactly a month in they charge my credit card $404 in addition to the $15 per session co-pays I had been paying. I immediately checked both the insurance claims and saw each session was being listed as out of network. I then contact both the insurance company and the billing office for the therapy company. The insurance company essentially says that billing will have to reach out to them. Billing is says that they will reach out and follow up. I never receive a follow up call. Instead I have to call back on my own and get told the issue is resolved and my balance is 0. I assume that means the issue is fixed, until I get another multi-hundred dollar bill. I call again, get put on hold while the person goes to talk to her manager. Then comes back and tells me they’ll look into it again, and in the mean time they are pushing my balance back to 0. I am also told if this happens again, she will leave a note in my file and to tell the person on the line to look at the notes. This keeps happening, I keep calling to be told essentially the same thing: they’ll look into it and get back to me and never do. Eventually, I stop seeing the therapist because, despite going through challenging personal things and having a rapport with the therapist, it became unsustainable for me to continue to field this bills. But nothing is ever resolved on the billing side.

I have since figured out that the confusion was around the difference between Anthem Blue Cross Blue Shield versus Blue Shield Basics, which are different carriers in CA (where I live) and my therapist was in network for one but not the other (which I realized on my own). When my insurance was initially noted, the person must have put down the wrong carrier. I am furious that this company failed to follow up and get to the root cause of the issue, all while telling me it was not an issue for months. In totally I had 13 sessions which should have costed me $195with my in-network $15 co-pay. In totally, they billed me for $1165. Is there any approach to make them honor an in network co-pay because of how poorly they handled this situation? Can the insurance company do anything about this.