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[quote=Anonymous][quote=Anonymous][quote=Anonymous]I wonder if there is a problem with the credentialing of these OON providers. [/quote]

For me, they are providers I have used for years and prior to 2026, filed claims and got reimbursed for my share. It appears to be a system problem at Carefirst, but [b]there has to be a limit on how long they can go without paying out claims.[/b][/quote]

You would think, but there seem to be no consumer protections on this front. I have been stunned that:
1. During open enrollment, CareFirst would not tell me what the allowable amount is for a specific service, even with the codes from the provider.
2. There is no disincentive for lying to consumers. CareFirst lied to me on the phone and via online messages multiple times, claiming my policy didn't cover certain services. They even sent me a random document that didn't apply to my policy. You can contest things and get the state involved and get your claims paid out eventually, but there is no penalty to the insurer for lying.
3. On the flip side I have had more than one provider that takes my insurance try to balance bill or simply refuse to correctly submit to insurance. Mistakes happen, but when it takes multiple long phone calls and emails to resolve something like this and me explicitly having to explicitly tell them they are prohibited from balance billing, it's clear that they are just pushing things to see what they can get away with. Some percentage of people will just give up and pay rather than deal with the massive hassle they intentionally create.[/quote]

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