What Are My Options? Anthem Medical vs. Vision: Site (intentionally?) Obscure Regarding Networks, End Up With Bill I Shouldn’t

I scheduled an eye exam last month and found a provider by following the directions in my vision benefits package. Go to Anthem.com, find an in-network optometrist; easy enough. Should be a $10 copay.

The ONLY signifier of which network a provider was in was small text that said either 'Medical Coverage' or 'Vision Coverage'. Right under the words "In Network" in bigger, bolded letters. I didn't know about this differentiator, because at that time I didn't see 'Vision Coverage' on any of the top providers in the list. Given I was specifically looking up an optometrist for an eye exam, and seeing "In Network" bolded, it's entirely reasonable for me as a consumer to think that I'd be covered. The 'Medical Coverage' beneath in small letters meant nothing to me at the time.

A couple weeks later, I instead get a bill for $200 because they billed my medical.

I reach out to Anthem and am told to submit to Grievances and Appeals, which I do for both medical and vision. In that appeal, I inform them that I followed the instructions provided to find an in-network provider and how the website was obscure. Medical side told me it could only cover as it's billed and coded, while vision just told me it never received a claim, so there's nothing they can do.

My question is what options do I have? Should I call them again, reiterate how obscure the site was (which at this point I think is entirely intentional for situations like this)? Should I call the provider and have them bill vision again even though they're out of network, then try to explain the situation to get them to cover as if it was in network? Should I contact the DoI on grounds of anti-consumer practices? Or is this one of those situations where I need to bite the bullet, pay the bill and learn for the next time?

submitted by /u/Ukoen
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