Need help navigating deductible issues

Hi all.

First of all, to set the context, I’m in California with blue shield PPO, a $2,550 deductible, and all doctors/facilities below are in-network.

So,

I began an evening IOP program April 5 and agreed to pay $2,550 to enroll. This amount is my annual deductible, of which I had paid $0 at the time. The balance of my stay is covered by my coinsurance, with my portion waived. So I basically met my deductible in one fell swoop, or so I thought.

About five weeks later, I had an unforeseen ER visit. This brought on a $1,300 bill. At this time, I noticed that none of my deductible had been met – it was as if my insurance company didn’t know I had paid that $2,550 to the IOP.

I do know blue shield have approved my IOP stay, and I getting semi-monthly approvals for my stay.

My question is: why wouldn’t my insurance know I had paid this $2,550? Did the IOP facility do something shady here? I have brought the issue to their attention, and got a bit of a confusing answer, but I did get a promise to refund the equivalent $1,300 so I’m not out of pocket extra – but am told it will take a while.

Can someone smarter than me about this please weight in? Happy to answer any clarifying questions.

submitted by /u/Alternative-Plan-678
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