I’m being told by my insurance company that this $1000 service isn’t covered because it’s out of network. However, my doctor is in-network and the facility it was done at (her office) is also listed as in-network on my claim. (In addition, all of the other related tests done within that 2-week period at that facility that were ordered by that doctor are being covered.) They’re saying the facility is “not contracted for medical services” and is only contracted for behavioral health, so it bills as out of network but just for this particular test. I have other claims that are billed to the same facility for the same medical issue from a week prior that are 100% covered. They’re telling me to reach out to my provider to see if they can submit the claim differently, but my provider said I need to work it out with the insurance company.
What tf do I do here? Submit an appeal? This is ridiculous.
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