Should I appeal if my health insurance won’t fully cover for my urgent care visit even though I’ve met my deductible AND out-of-pocket max?

So…l was charged $250 for an urgent care visit. I made sure the facility I went to was Tier 1 AND in-network. I also met my Tier 1 deductible AND my out-of pocket maximum so my insurance should've covered it.

I called my insurance (BCBSM) and Apparently it doesn't even matter what tier the urgent care is. They billed me based on the physician that serviced me at that time, and she's Tier 2… So I have to request for a Tier 1 physician every time I visit an urgent care (IF they even have one). Is this the same for everyone else?

My only other option is to fill out an "appeal form" which takes 60 days for them to review and get back to me. Are there any other steps I should take before I have to appeal? None of this makes sense or sounds right to me.

My coworker never met her deductible or OOP max and she never had to pay anymore than $30 for her urgent care visits. I'm on the essentials tier plan and I believe my coworker is on the same one. Not sure why I'm being billed ditterently.

Please help

submitted by /u/Professional-Net-176
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