Insurance refusing to pay for in-network doctor?

Hi, can anyone explain to me and my family what the hell is going on with our insurance?

My dad started seeing a new physician that accepts our insurance, but apparently the insurance company is refusing to pay the doctor.

Crazy thing is, my dad found the doctor on the insurance company’s recommended list of in-network doctor’s within our area. And the doctor confirmed that he accepts our insurance… yet our insurance company is refusing to pay.

My dad’s doctor has contacted them multiple times to figure out what is happening. The doctor said that the representative he spoke to claimed that he was out-of-network, and instead of trying to explain the situation further, the representative was apparently rude and hung up on the doctor.

We’re all taken aback by this. Currently we are speaking with an insurance agent to help us switch companies for the upcoming year. We are tired of the insurance we have–this is the last straw.

I could write an entire book over the insane and unhelpful experiences we’ve had with this insurance company (it’s a local one to my state btw). For example, I had issues with the representatives after being told conflicting information about prior authorizations, and also when I found out a medication on the “most updated” formulary for my plan was actually not covered on the formulary anymore.

My family feels as if we are wasting money on an insurance company that can’t even provide any services for us. I’ve had to skip over appointments and not pick up medications that were prescribed to me because the insurance would not pay for them, even if the information on their site, my insurance card, and/or plan documents stated otherwise.

I’m going to have my father file a complaint with the state insurance department about what happened with his doctor. Is there anything else we can do? Also, does this situation sound fishy to anyone else or is there a legitimate possible reason why the company would deny an in-network yet out-of-network doctor???