(ME) Insurance website says provider is in network, but recent visits were billed as out-of-network; insurance tells me provider is both in-network and out-of-network.
Plan is UHC Choice Plus with Harvard Pilgrim through my employer.
Pretty much the title.
We got our child into a new pediatricians office. All my verification with UHC's website said the provider is in network – all good! We schedule two visits with this same provider. I was not asked to pay at the time of service either visit.
Months later I get a $300+ bill in the mail for these visits. I checked the recent claims on UHC's website, and the claims state this same provider is now out-of-network. When going to the "Find Care" section to check providers, it still states the provider is in network as of this writing.
What is my recourse here? Who do I call to get this fixed? This has actually happened once before a few years ago, and my employer's benefits team entirely put the blame on me for not validating the provider properly (even though I also validated this at that time too). Dealing with any billing issues with this plan and the local hospital network that I'm unfortunately locked into (due to distance from other providers) has been absolutely infuriating; providers' billing office is clueless, insurance blames the providers for not filing claims properly, and my employer blames me.
I'm doing my due diligence and I am still getting screwed.
</rant>
submitted by /u/EmotionalBuilding945
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