If I go to an in-network clinic/practice, will all of the doctors there be in network as well?

I am looking to have a procedure done which would be covered by my insurance. I called customer support to make sure that I would be covered and see what I would be liable to pay. When I told the woman from customer service the name of the doctor that I had spoken to about getting the procedure done, she said that she didn’t see her on their list of in-network doctors. I told her the name of the practice I’d seen her at as well, and she didn’t see the practice in-network at the right address.

After getting off the call, I looked into it, because I had not had issues going to that practice in the past, and it actually goes under a different name in the health insurance system. (Privia Health) When I search for this on the insurance website, the correct address comes up, as well as several doctors that I know work at the location. However, my doctor, and the doctor that I would like to have the procedure done by, does not. I am wondering if my doctor (who does not work elsewhere, only at this clinic) is in-network for me because the clinic that she works at is, or if she is not and I will have to find a new doctor.

The customer service agent also said that I could have my doctor order the procedure and then have it done by someone in-network, but that she wouldn’t recommend that because it would complicate the insurance process.

If anyone has a definitive answer, I would be happy to hear it. Thank you.

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