Therapist says they are out of network

I've been seeing a therapist for the past two months. Basically, she says she is out of network with my insurance (she doesn't accept insurance at all) and my insurance insists she is in network. As a result, my insurance is only reimbursing me about 30% of the fee instead of 80% out of network reimbursement. For example, my therapist charges $150. My insurance says the in-network rate for her is $45. I expected to received $150*0.8 = $120.

Here's what I understand the situation to be:

My therapist practices at two facilities: an in-network facility (where she is in-network, call it Facility A) and her own private practice (supposed to be out of network). I see her at her private practice. If I look up Facility A on my insurance's provider search tool, it shows as in-network. If I try to find the therapist, she does not show up at all. I had just searched by the therapist name before starting therapy, which is what led to believe she was correct about being out of network. My provider has called a few times now. She gives the insurance her private practice tax ID and her NPI. They say they'll reprocess the claim. I call to check on the status and they tell me they determined she's in-network under that tax id. My therapist insists the insurance has this wrong. She might show up as in network under the NPI only (from Facility A) but anything else is an error on the insurance company's part.

I'm at a loss how to get this resolved. It's a lot of waiting while both sides insist they have it right. I'm not getting reimbursed at the rate I thought and the bill is starting to accumulate. Any advice is appreciated.

submitted by /u/Ancenterm
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