In-network doctor, billed out-of-network facility. Neither provider nor Cigna will budget. What do I do? Colorado.

I will try to make this as simple as possible because fuck me it is complicated.

I saw a Dermatologist back in Sept 2021 who is verified in-network for me. Two months later I am receiving a bill for $200-something dollars because Cigna processed the claim as out-of-network. This Dermatology office uses a third-party medical billing group to bill/submit claims. I called the medical group and they said they submitted the claim using the facility NPI, not under my doctor’s NPI. The facility is out of network.

I hashed it out between the billing group and insurance. Insurance said that the billing group needed to resubmit a claim under the doctor’s NPI, not the facility NPI, and the medical group refused to at first, but then later relented and said they would re-submit. A year goes by, and lo and behold I’m getting a bill for $200 again.

I called Cigna again and apparently this medical group billed under the facility NPI again. I hadn’t received a bill since they resubmitted. Now Cigna is saying “tough titties” because “that’s just how they billed it”. I even gave them the reference number for the first time I called Cigna and they said “nope sorry we don’t see anything in the notes” (of course). The medical billing group is also saying “tough titties we’re not resubmitting a claim”. This feels so fucking wrong. How is it that I can see an in-network doctor and still be processed as out of network?!

Is there ANY recourse here? I’m on the hook for a $200+ medical bill for a doctor I saw that was in network!?