And neither the hospital nor my insurance could articulate why it was denied.
In October of last year I had a routine colonoscopy at an in network hospital with an in network doctor. I checked before going in, hospital was listed as in network and I had seen the doctor prior and claims were paid to him prior. A few weeks later I got an EOB stating $23,000 was denied as 'out of network' but they paid the doctor that was there that day? Insurance agreed with me, on the phone multiple times, that the hospital was in network but the claim was denied as out of network. Then they started feeding me lies, saying the NPI was submitted wrong, my SSN was submitted wrong, the "tax ID" was wrong, anything to pass the buck and get me off the phone. So I followed up with the hospital and doctor, everything on their end was correct and as far as they could tell me submitted correctly. I called the hospital billing call center and they could tell me nothing except "the back end team is working on it". 6 months later I get a hospital bill for $20,000 in the mail. I guess the "back end team" didn't work it out. I'm still totally in the dark as to why it's being called 'out of network' so now that I have a hospital bill I can start appealing it since it's no longer "in process". 6 freaking months tho!?!?
So now I need to waste more hours and deal with more stress about some clusterfuck that's not my fault and at best the claim is paid with no reimbursement for my time and agony and at worst there's some stupid little loophole that I somehow missed and now I owe $23,000 for someone to look in my butt.