What is the name of your state? PA
Okay, I'm going to try to explain this and hopefully it will make sense. I'm asking this question on behalf of my parents. My Dad had surgery a few months ago. He went about everything correctly (referral,ect). The doctor that did the surgery was a part of a group that was in network. Around the time of my dad's surgery, the doctor began working with another group of doctors, also in the network. It just so happens that the day the doctor did my dad's surgery, he was considered to be in some sort of "limbo", in between those two doctor groups. It is showing that he was not in the network when he performed the surgery because he was in that "limbo". The insurance company is refusing to pay for the surgery and my parents are being billed. Can they fight this? Do they have to pay? It seems like it was a mistake with the Doctor, and the dispute should be between him and the insurance company.
Okay, I'm going to try to explain this and hopefully it will make sense. I'm asking this question on behalf of my parents. My Dad had surgery a few months ago. He went about everything correctly (referral,ect). The doctor that did the surgery was a part of a group that was in network. Around the time of my dad's surgery, the doctor began working with another group of doctors, also in the network. It just so happens that the day the doctor did my dad's surgery, he was considered to be in some sort of "limbo", in between those two doctor groups. It is showing that he was not in the network when he performed the surgery because he was in that "limbo". The insurance company is refusing to pay for the surgery and my parents are being billed. Can they fight this? Do they have to pay? It seems like it was a mistake with the Doctor, and the dispute should be between him and the insurance company.