Out of network with primary, in network with secondary

I would appreciate any help navigating my situation as I'm scared of the onslaught of medical bills coming my way.

I have Kaiser Permanente as my primary through my employer, and I also have United Healthcare as my secondary through my husband. I had my husband add me to his insurance last year as I wanted to see a specialist in-network with UHC, but not with Kaiser, because I was unhappy with Kaiser's care (long story short, I'm dealing with iatrogenic reproductive health problems as a result of procedures done by Kaiser doctors).

I saw this specialist a few weeks after I was added on UHC, and because I (my fault, I know) did not realize how primary and secondary insurance worked at the time, did not give them my Kaiser insurance information. To my defense, when I had initially asked UHC the person on the phone said the doctor would not even need my Kaiser insurance information since it was out of network anyway. So I ended up having a minor surgical procedure with this doctor last year in the summer, then another bigger, general anesthesia surgery earlier this year.

UHC denied the claims last year due to COB issues, which when I found out how that worked, immediately notified the doctor and hospital so they could bill Kaiser as primary then UHC as secondary. This took some time, but I thought everything would be fine now that they had the correct insurance information, and so I proceeded with the bigger surgery this year.

However, UHC has denied all claims, claiming that they processed it according to how primary did it. Kaiser's EOB states it was "denied, not authorized" because obviously this doctor and hospital are OON and Kaiser has no OON benefits. But why would UHC deny it for same reason when this doctor and hospital ARE in network with UHC? What's more confusing is, under the EOBs from Kaiser and UHC, it says patient responsibility is "$0", but now the doctor has billed me. The doctor's bills aren't as scary as the hospital surgical bills, which they haven't billed me yet but will be more than $100,000. So obviously I'm freaking out.

I would appreciate any guidance to what I can do here. I've appealed to Kaiser so far to get a letter stating the services are out of network as I guess the EOB didn't make that clear, but I don't now if that will be enough for UHC to reprocess claims.

submitted by /u/donutnbrownie
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