Forgot to submit insurance after annual physical, now on the hook for $495. Is an appeal likely to be successful and is there anything else I should add to my appeal letter?

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Hi,

I had a standard annual physical + a lab visit in October of 2019. I forgot to provide insurance information for the office visit on my way out. The bill then passed the 90 day mark (criminal policy IMO) for submitting insurance information & I am now stuck with the bill. Somewhat irresponsible, but I’m 27 and have had my own insurance plan for under 2 years of my life and have never had to deal with this. I did eventually provide information for that office visit.

I’ve spoken to both the billing department of the provider and BCBS Massachusetts’ customer service representatives about the situation and both have agreed that this should not be the member’s (my) liability. However, when the bill was finally resubmitted to BCBS last week, they denied it, citing the same 90 day rule that they cited when I had previously provided info.

My appeal letter is roughly the same as what I spelled out here, plus it cites the name of the customer service rep & the date that I spoke to her on. We had a 3 way call with the provider discussing the situation where we (provider and BCBS) concluded this should not be my liability.

Is there anything else I should include? What should I expect from this?

submitted by /u/baby_come_on
[link] [comments]
Hi, I had a standard annual physical + a lab visit in October of 2019. I forgot to provide insurance information for the office visit on my way out. The bill then passed the 90 day mark (criminal policy IMO) for submitting insurance information & I am now stuck with the bill. Somewhat irresponsible, but I’m 27 and have had my own insurance plan for under 2 years of my life and have never had to deal with this. I did eventually provide information for that office visit. I’ve spoken to both the billing department of the provider and BCBS Massachusetts’ customer service representatives about the situation and both have agreed that this should not be the member’s (my) liability. However, when the bill was finally resubmitted to BCBS last week, they denied it, citing the same 90 day rule that they cited when I had previously provided info. My appeal letter is roughly the same as what I spelled out here, plus it cites the name of the customer service rep & the date that I spoke to her on. We had a 3 way call with the provider discussing the situation where we (provider and BCBS) concluded this should not be my liability. Is there anything else I should include? What should I expect from this?
submitted by /u/baby_come_on [link] [comments]Read Morer/HealthInsurance

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