<prompt> Human: I made an appointment with an in-network doctor this is for chiropractic. Turns out, this doctor no longer works at the office, so I was set up with another doctor. In our initial meeting, this new doctor told me that hed spoken with my insurance company and Id pay a small copay my insurance card states that in-network chiro has a copay of 15, so I agreed. Now, Im getting EOBs from my health insurance, Cigna, that lists this doctor as out-of-network and is charging me well above the copay I agreed to.Who do I contact? My provider, or the insurance company? What do I say? Do I have recourse?Assistant: Also, I still havent received a bill from my doctor-- just the EOBs from Cigna. Should I wait to receive a bill before reaching out, in case theres something happening behind the scenes, or should I call ASAP?Human: I work in the provider services department for an insurance company. First, call Cigna or if they have an online find a doctor tool, which most insurance companies do - go online and check. Otherwise call, verify if this particular physician is in-network or out of network. If its a chiropractic clinic, have them also check if the clinic is in-network. Sometimes a new physician gets a job at a clinic and the paperwork takes awhile to actually add them. Most all insurance companies have a rule where if a clinic is in-network, they are not allowed to bill for non-contracted providers, which could explain why you have not gotten a bill yet. Secondly, check on your cigna explanation of benefits if the remark code usually towards the bottom has a code of CO or PR - CO is contractual obligation and would mean you are not going to get billed for that amount, PR would mean patient responsibility. Ultimately, if the physician is not contracted, dont make any future appointments and contact the billing manager at the office and explain the situation, I am sure they would work out a reasonable agreement with you and being a chiropractic visit the bill shouldnt be that huge unless you had an x-ray or mri done at the time of visit.Assistant: This is SUPER helpful. One question: if the clinic isnt allowed to bill for non-contracted providers, how do I know what Im supposed to pay?  <response>: I work on the other end - Im a biller at a doctors office. Definitely start by calling your insurance company as they make the ultimate determination on how much you are responsible for paying to any doctor. If any doctors office ever tries to charge you a different amount than what your insurance company has said youll be responsible for, always stop and confirm everything with your insurance first. Insurance companies accidentally processing as out-of-network actually happens pretty frequently. Its happened to me personally before and it was solved with one phone call to my insurance company asking them to just double check. If you call your insurance and they are still showing out of network, Id next call the doctors office, speak to the billing manager, and ask if theres a separate NPI or TaxID number for the provider you saw. We have two doctors at our office, and they operate as a group as well, so there are three separate NPI numbers that insurance companies use to determine if a doctor is in network. Sometimes we have to call and ask them to run a different NPI number to show theyre in network. Good luck! 