Why did my provider at the same location change the place of service from "office" in 2022 to "outpatient hospital" in 2024/is that allowed?

Hi, I made another post last week trying to figure out why my insurance was not applying my copay towards doctors visits and with your help discovered some visits were coded as office (11) and some as outpatient (22). I’ve seen the same PCP under different insurance since 2021, and upon calling my old insurer, they said her visits were always coded under #11 as an office visit. Now, in 2024, my claims and bills are coded as #22 outpatient hospital. I still see her at the exact same location, which is 2-3 blocks away from the hospital. The building is labeled as part of a university, and only the floor she works on is affiliated with the hospital system that’s charging me.

Is it legal for them to change the place of service without changing provider or location? I know it was 2 years between the claims/visits, but they did not change any of the paperwork I sign or anything else.

Also, I need help with who to report the hospital to if they don’t address my concerns. I was planning filing a complaint with CMS, maybe the BBB, anywhere else I can do? Do I have to make a complaint against the providers specifically?

See also  EOB sent but no bills from provider