Doctor in Network but facility is not. I didn’t know until the bill.

Editing to add: I am 29, in Texas

I got a colonscopy and endoscopy done by a doctor in network. The facility and doctor billed my insurance separately. Before the procedure, I received calls from both to pay my copay. I didn’t know until afterwards that the facility was out of network. I check my insurance website beforehand and it said it was in network and when I paid my copay, the facility said “after insurance you’ll owe $$$” and did not say anything about it not being in network. Afterwards, the doctors bill was approved by my insurance but the facility was denied. The facility is the only place that the doctor does procedures.

I tried to appeal through my insurance but they said that the facility is out of network. They said this is an error on the facilities part and to not pay my bill yet. They said they will be reaching out to the facility but didn’t give me details in what they were going to do.

Has anyone had something similar happened?? Did it get resolved? If my insurance isn’t willing to pay, what else could they do to help me?

submitted by /u/NecessaryShare5081
[comments]

See also  Insurance changed provider Tier without notifying