BCBS of MT Blue Focus POS – billed for OON when website says in my network?

Hi all, I suspect I'm up the proverbial creek financially but thought I'd check here just in case I'm missing something.

I'm 39, live in 59101. Made a bit over 43k last year, will likely make less this year because of time off/short term disability from multiple surgeries. BCBS of MT, Blue Focus POS (bronze) through the marketplace.

I had surgery out of state in April. I searched BCBS's provider finder beforehand and confirmed (so I thought) that the surgeon and facility were in my network. I did this by searching in the zip code of the city they were in, not my zip code, cause duh they're not even in my state right? The hospital, surgeon I went with and the head surgeon all had the note "In your network". I had pre-authorization so I didn't call BCBS to verify what was and wasn't in network which I suspect is now coming back to bite me. I did sign paperwork from the hospital and surgeon about perhaps getting billed for out of network services, which I expected might be the case for something like anesthesia and labwork, not everything. Nothing at all was applied to my in network deductible or OOP. I got a bill for +10k from the hospital and have been trying to get answers from BCBS. My surgeon and the hospital both billed insurance separately, each EOB has notes about being out of network and each line item has discounts/what I owe. On my fifth call about the hospital EOB, BCBS finally said that the surgeon is listed as OON on their side. The rep I spoke to said that I needed to search their provider finder with my home zip code not theirs to see if they're in my network. Does this sound right? The surgeon who performed the surgery bills under the name of the head surgeon of their medical group, they are not part of the hospital, and I got a separate EOB for them. If the surgeon isn't part of the hospital why would that affect things like drugs and facilities?

Here are EOB for hospital and surgeon – https://imgur.com/a/ms404PJ

This is a screenshot of what the hospital and surgeon "in network" notes look like – https://imgur.com/908zYvP

The more specific one is when I search when logged out. Before I called today the first line (logged in search) said "In your network" not "In "" network" which has now got me paranoid. I just quickly got screenshots of surgeon & hospital search results from being logged out showing that it lists being in Blue Focus POS network. Unfortunately I don’t have screenshots of anything that says “In your network”.

I went out of the state because I couldn't find anyone in the state who works with my specific gender expansiveness and/or was willing to operate on my general expansiveness. I'm filing for financial assistance/a payment plan with the hospital, this is especially tough because I've paid already paid my +9k in-network OOP from another surgery in January and my short term disability hasn't even acknowledged receiving my claim for the April surgery. Argh!

Thanks for reading my rambling!

submitted by /u/agoodreword
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