EOB says in-network, Provider says not covered

Edit: Here is a copy of the EOB I have and the most recent bill from medexpress.

I've posted this before and am so confused! I don't want to have the bill go to collections.

Son went to MedExpress. Paid copay. Provider sends me bill for remaining. Independence BCBS denies claim because it wasn't sent to the right BCBS. EOB states "T5428 – This service was performed by a network provider. This claim should be submitted to the Home Plan directly."

Tons of 3 way calls, back and forth, paper claims, with instructions on where to send the claim. This has been escalated by insurance (Independence BCBS) and I have in writing saying they've had education calls to inform provider on how to send the claim correctly. Medexpress keeps sending the claim to Hallmark BCBS instead of Independence BCBS every time.

I just got a new statement dated 5/1/2024 from MedExpress that I still owe and it says "Your insurance provider, BCBS-PA Independence BC, notified us that you were not covered under their plan. This balance is your responsibility. If this is incorrect, contact your insurer." Huh? EOB says in-network.

I sent the bill back with a copy of the EOB that says I don't owe. I told Independence BCBS this and they said they have no record of Medexpress resubmitting the claim.

What do I do? I am dumbfounded on how this cannot be easily solved.

submitted by /u/No_Panda_9171
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