I have a dispute with my health insurance company and I don't know my recourse. The short story is my wife got hearing aids which are covered under our plan from an in-network audiologist. However, the doctor works in an office which is not in the network and the insurance saw that and thus paid a fraction of the allowed amount. They suggested we get the audiologist's NPI number and send it with a claim resubmittal and that that should resolve it. However, we did that but they just repeated that the group wasn't in network and kicked it into internal appeal. So, at this point I am wondering how insurance companies are required to deal with in-network doctors in out-of-network offices when processing claims. Also, if this appeal doesn't end in my favor, I wonder what my recourse is because I don't think this is an issue that would qualify for external appeal. Any help at all would be most appreciated!