Gov Insurance- incorrect in-network info from provider

GIC insurance- incorrect in-network info from provider

I recently went to a medical group that told me they are within network with my insurance (WellPoint – a GIC insurance so that’s for government employees and their families).

Before I started with them I also confirm the doctor I was seeing was in network as well and they told me he was.

Subsequently I’ve seen the doctor 6 times and after multiple months of speaking to the insurance and the medical group, it seems they themselves are a part of the network but the doctor is not. Different people from the insurance group told me different things- they have used the wrong modifier code, their provider portal is not up to date but the bottom line is they gave me incorrect information.

I sent over a complaint form to the GIC (I tried complaining to the Massachusetts insurance commission but they told me it’s government insurance) and I also sent a complaint to WellPoint about the medical group.

Is there anything else I can do? They have processed all these claims as out of network after telling me they are in-network

I have stopped going to them and am now keeping everything in writing via email.

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