I had to go to the ED and have an emergency procedure back in December. Multiple claims for different doctors that were considered out of network (since it was an emergency it is all covered anyway)- two of the claims were processed wrong due to “out of network.” I had to spend a month, talking to customer service representatives who were extremely unhelpful to finally talking to a supervisor to reprocess the claim which took weeks to fix. Tiring. Now the last claim for the anesthesiologist just got processed and it’s wrong stating he was out of network like the other two previous claims. Now I’ll have to jump through hoops to talk to someone with any sense to get it reprocessed. Who reviews the claims? Is it a computer system? Because if it was an actual person why can’t they just review all of the claims and see that all of the procedures and doctors treated me on that same date under emergency care. I just don’t get it.
submitted by /u/Pearl1948
[link] [comments]I had to go to the ED and have an emergency procedure back in December. Multiple claims for different doctors that were considered out of network (since it was an emergency it is all covered anyway)- two of the claims were processed wrong due to “out of network.” I had to spend a month, talking to customer service representatives who were extremely unhelpful to finally talking to a supervisor to reprocess the claim which took weeks to fix. Tiring. Now the last claim for the anesthesiologist just got processed and it’s wrong stating he was out of network like the other two previous claims. Now I’ll have to jump through hoops to talk to someone with any sense to get it reprocessed. Who reviews the claims? Is it a computer system? Because if it was an actual person why can’t they just review all of the claims and see that all of the procedures and doctors treated me on that same date under emergency care. I just don’t get it. submitted by /u/Pearl1948 [link] [comments]Read Morer/HealthInsurance