Someone during surgery was not "in network," now the claim might possibly be denied

I had surgery in May. It was a necessary procedure, a total thyroidectomy, due to thyroid cancer. I saw an ENT surgeon who was in network and he performed the actual surgery. He works in an independent practice, but he performs the surgery regularly at the local hospitals ( 2 to 5 a week, has been doing this for over 30 years). When I was asked where I wanted the surgery done (which hospital), I chose the hospital in network. There are two hospitals in our area, and supposedly I am covered under both, but I chose the one I new was definitely in network.

Anyways, I was reviewing my claims and one of the claims is currently “in process,” but it is flagged as “Out of Network.” I cant do anything with it right now as it is still in process, but has anyone had this before? It looks like a specific doctor (one I never met) is in network. He is claiming three services, two muscle/nerve study and an intraoperative monitoring. The claim itself is labelled as “remote neuromonitoring physicians pc.” I am assuming this was something necessary for the surgery, I dont know what for except I was told my ENT (so not the dr in question) does test the vocal cords to make sure they are working after the surgery. So I dont know if it is related to that, or if they are monitoring something else.

Can I appeal this if it gets denied for “out of network”? Its not like I chose this person, I was not given a selection on anesthesiologist, nurses, cna, or whatever professionals are there during surgery.

See also  Daughter needs infusion and both insurances are saying they are primary, so pharmacy won’t give us the meds.

If I cant appeal this if it gets denied, how do I prevent this in the future and only having doctors in network? I will be needing future testing, etc for unrelated issues and I dont want to be in the same situation.

Edit to add: I live in the US just in case someone is asking.