We are an out of network provider with Cigna, but yesterday I received an EOB for a claim that had been processed with a plan discount, that should not have been there. We billed $145 and the discount was $60.17 with the remaining $84.83 applied towards the patient's deductible. So I called Cigna and they stated that I have to call Data iSight (third party pricer) to have the discount removed. So I called Data iSight and they stated I have to appeal their pricing to have the disocunt removed and then I can get a corrected EOB from Cigna. How can an insurance company have these claims repriced and then send out the EOB without having the provider agree? I get requests all the time from out of network inurance companies wanting to negotiate, but they don't process the claim until they have received a yes/no from us. Has anyone else encountered this problem? How can the insurance company do this? Is this a ploy to make it difficult for an out of network provider to get paid, therefore, resulting in the provider just taking the discount or deciding to join the network?