Provider billed a "specialist visit" consultation as an "outpatient hospital service" since they bill through a hospital network. Now they say I owe an additional hospital service copay of $500 instead of my specialist visit copay of $50.

I have a $50 copay to see a specialist, but $500 for outpatient hospital services. I assumed this hospitalization meant things like getting surgery, not going to an office appointment with a doctor for a 5 minute consultation!

I called my insurance and they said the bills are correct which means I owe $1,500 for 3 follow up appointments. They said I will owe the hospital charge anytime I do anything in a hospital. They said it all depends on how the provider chooses to bill for the appointment. If they bill it as just an office appointment, I’ll only owe the $50 copay. They said both ways are proper. This makes no sense, I didn’t consume any hospital services except 5 minutes of the doctor’s time for the appointment.

It’s very unclear even what is a hospital. Every health clinic, urgent care center and medical office has the name of a hospital under it. Even local businesses like gyms are owned and operated by these major health networks. Doctors also often have many locations or split their time between an independent facility and hospital.

I’m struggling to find any specialists in my area that aren’t part of one of these hospital networks which means I have an effective Copay of $500 to see a specialist, right??

This makes no sense. What is going on?