Claim rejected because Doctor’s NPI number shows an out-of-network old address
I saw an out-of-state doctor (TN), but my plan covers his state. He ordered labs for me, which I got drawn at a LabCorp in my state (AL). My local state BCBS of AL rejected the diagnostic tests claim, saying that the provider (LabCorp) needs to file with the BCBS division that the doctor is located in, and then I am covered. Fine, except that his NPI number shows an old practice location and mailing address in Florida which is out-of-network! So LabCorp is refiling the claim, but with Florida BCBS, and BCBS of Alabama is saying they will process the claim as out of state, meaning that the huge LabCorp bill will hit my out-of-state deductible. I will add that my plan covers in-network diagnostic tests at 100%, and has always done so when I get labs done at this particular LabCorp location. Is there any way to solve this? It would not be an issue if my Doctor's NPI database information showed his actual practice location in TN.
submitted by /u/CryptoTrader2100
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