Can I appeal my insurance’s decision to revoke my reimbursement? If so, how?

Hi everyone! I’m currently seeing a specialist for a health issue. The person is out of network, but I was told by their office that I would pay a $500 deductible and then my insurance would reimburse me 40% for future appointments. This has worked out fine for about 6 months. I’ve received a “superbill” every month, and the insurance company has reimbursed me. Today I received an email from my insurance company telling me that they were reimbursing me because they believed I was seeing the licensed provider (who owns the practice), but I was seeing a not-yet-licensed person working in the practice as part of their internship work. Now they want me to return all of the reimbursed payments. They said I have 180 days to appeal the decision. Do I have any recourse? I’m in CA. Thank you!!

submitted by /u/trupolipsy20
[link] [comments]Hi everyone! I’m currently seeing a specialist for a health issue. The person is out of network, but I was told by their office that I would pay a $500 deductible and then my insurance would reimburse me 40% for future appointments. This has worked out fine for about 6 months. I’ve received a “superbill” every month, and the insurance company has reimbursed me. Today I received an email from my insurance company telling me that they were reimbursing me because they believed I was seeing the licensed provider (who owns the practice), but I was seeing a not-yet-licensed person working in the practice as part of their internship work. Now they want me to return all of the reimbursed payments. They said I have 180 days to appeal the decision. Do I have any recourse? I’m in CA. Thank you!! submitted by /u/trupolipsy20 [link] [comments]Read Morer/HealthInsurance

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