This is the claim for my ear infection visit in July, to my Primary Care Physician (PCP), who is most assuredly in-network, and not out-of-network.
I just found this online. It's after business hours, so I can't talk to a human until tomorrow morning.
They paid my last claim wrong, as out-of-network instead of in-network. I called several times to complain and it was never resolved, and I finally paid $5 I didn't owe just to shut everyone up. Obviously, my doctor is coded wrong in the system. It's possible they have him on file twice, once correctly and once not.
I used to work on insurance company provider files, and know all kinds of wrong things can happen. My favorite was the doctor which the system truncated to "Dr. so-and-so, Professional Ass" when it should have been "Professional Association." He, understandably, complained; to fix it, we had to use Asc since the system truncated after a set number of characters. Whether he actually was a professional ass, I don't know.
I hate when this stuff happens!