How does insurance co know how much I’ve paid out of pocket?

I just had twins who stayed in NICU from December 2020-end of Jan 21. I believe it’s caused some issues w billing and blue cross is trying to hit me with more than my out of pocket max but they’re phone reps seem clueless. First question is how does insurance company know exactly what I’ve paid out of pocket to the billing doctors if I settled with them for a lower price ?(after insurance ready paid them ) Thanks

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I just had twins who stayed in NICU from December 2020-end of Jan 21. I believe it’s caused some issues w billing and blue cross is trying to hit me with more than my out of pocket max but they’re phone reps seem clueless. First question is how does insurance company know exactly what I’ve paid out of pocket to the billing doctors if I settled with them for a lower price ?(after insurance ready paid them ) Thanks
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