Is this insurance fraud or just error in billing

Hello,

My therapist is apparently in-network per my insurance provider. For the past year, they have been billing/submitting claims through a different provider address. My insurance provider considers them out of network since the bill is not from the correct address. I looked up the doctors license and see that they have 3 licenses, two of which are expired and located at the address they are billing from. Again, this address is not in network per my insurance provider. The ONLY valid license is at the correct address, which is the doctors office and the address the insurance provider considers in-network.

I'm not sure if this is on purpose or a mistake by the doctor….but I have been getting billed and paid as if they are a out of network doctor for a year now.

I'm going to tell the doctor they need to fix this and they are using an OLD, EXPIRED license number/address.

But I'm wondering – is this fraud or just a billing mistake?

submitted by /u/gzjzltjz
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