Still can’t get a straight answer regarding what’s in network

New Hampshire- Anthem BCBS Our plan states that labs are covered 100% before deductible at in-network labs. Myself and my children had labs at various in-network labs affiliated with two major hospitals, one urgent care, and even a Quest lab. All of these were in-network and our responsibility was 0. My husband and one child had labs at a different hospital. Some of the lab work was identical lab work to what I had done elsewhere. This hospital lab was also in-network. The difference is that they charged our deductible, which is $3000 per person.
I have scoured every inch of the plan and I cannot find any reference to anything that indicates what differentiates this particular lab from any other lab that we have been to.

Admittedly, there is a long list of lab facilities and how they will be charged- some will be pre- deductible and some will be post-deductible. They are named vaguely such as “lab outside hospital” “outpatient hospital lab” “Dr office outpatient lab”. There is no guide to tell you what any of this means. I went to what I would consider a lab at a doctor’s office, and I had no deductible. My husband went to a lab at a doctor’s office, and had to meet his deductible.

So I have called Anthem to ask about this, and no one there knows either. The only explanation they can give is that some facilities are subject to deductible and some aren’t. Well yes, I now realize this, but how do we know which ones? The reps look at the list and they also have no idea. So my next step was to file an appeal. It was denied, in reading the denial it is clear they still have no idea what my question is. I am not disputing that the service was provided. They still have yet to explain how the service we are being billed for differs from the identical service that we were not billed for.

I also tried to reaching out to the hospital. They have been great and our bill is in limbo, not in danger of collections. They know I am working on it with Anthem. But my frustration is that Anthem can’t seem to understand what I am asking them. And every time I call I am routed to a call center in India and I have to explain some basic background info about the local hospital setups before I can even begin.