Doctor and medical group are in network but the doctor bills using an ID number that is out of network
I have BCBS PPO, So I went to see a doctor that I have been seeing for over a year. The medical group the doctor is with and the doctor are in network. My past 5 appointments have been covered 100% beside a $30 copay.
Well my last appointment was billed at $291 and insurance only covered $95 leaving me with a $195 bill. So I called my insurance and they said basically the only difference between the most recent appointment and the past appointments is the “PFIN number”. Its basically the physicians ID number and for some reason it is different from my past appointments that have been covered.
So even though the insurance person confirmed that the doctor and medical group are in network, because of the way she billed the last appointment, they’re billing it as out of network.
I don’t know what to do next. The insurance person said she’s gonna have the claim reprocessed and corrected but I don’t want this to happen everytime I see the doctor. This pisses me off so much because how the fuck can the insurance company say they’re in network but because of one small ID number bill it as out of network. I’m so angry.