Submitting claims to Anthem BCBS for healthcare in MA

I recently retired and switched to my wife's plan which is Anthem BCBS. I saw a provider who is listed as in-network, but the EOB showed the provider as out-of-network and I therefore didn't get the negotiated rate. I spoke to a CSR at Anthem who said that the reason this happened was because the claim was submitted directly to Anthem when it should have gone to my local BCBS (BCBS MA). The CSR called the provide on my behalf and asked them to re-submit, which they did. Then Anthem denied the re-submitted claim as a dupe!

I called Anthem back and a different CSR said that he'd send the original claim back for review and re-processing since it was incorrectly marked as OON. When I asked whether it's true that the claim should have been sent to BCBS MA, he didn't answer directly and just said, "Anthem and BCBS MA are the same thing."

So my question is: Is it true that claims should be sent to BCBS MA instead of directly to Anthem? If so, is this just something that providers are supposed to know how to do?

submitted by /u/bjl218
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