$20K colonoscopy, when dr’s billing office said $50 in email?

[u/Antique_Ad3823]

Had a colonoscopy by an in-network doctor, at their own surgery center. Before the procedure I spoke with the doctor and billing office to make sure it was all in-network. They confirmed in writing via email, explicitly said I’d only be responsible for my $50 co-pay, with no out-of-network charges.

Weeks after I get 2 denial EOB letters from my insurance, saying the surgery center and anesthesiologist are out of network, and I’ll owe $20K. After some googling it looks like the surgery center and anesthesiologist aren’t in-network with any insurance!

What is happening? Will the doctor’s office really come after me for $20K, when in writing they said I’d only be billed for $50? If so, what can I do? I’m not sure if No Surprises Act will cover this.

[u/[deleted]]

Be careful with the online directories. They are often not up to date and the insurance doesn't feel bound by them.

[u/Honju → u/[deleted]]

100% This. I spent several phone calls arguing this with bcbs because their portal said my provider and facility were in network but my EOB said they were out of network. 

I literally had multiple reps on the phone with me use the portal and go “huh. They are in network” tell me they’d submit it for review, then the review was denied. I finally got it covered after 4 attempts at this

[u/Comfortable_Two6272 → u/[deleted]]

I had screen shots and filed complaint with state insurance commission. Ins then paid as in network.