[South Carolina] My health insurance plan has a program where if I go to a specific doctor’s office, I will only owe 10% coinsurance instead of 20%. BCBS confirmed my doctor’s office participates. Well the claims are being submitted as “X Pediatrics” instead of “X Family Practice.” The incorrect name they are submitting the claims under is not even at the same physical location as where my doctor’s office is located. The reps at BCBS are throwing it back on the doctors office saying they need to resubmit using a different tax ID #. What are my options if my doctors office refuses to do this? It seems like I can only appeal claims at BCBS if they are denied. It wasn’t denied, just wasn’t paid correctly. Would my State Dept of Insurance help me at all?
submitted by /u/je03955
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[South Carolina] My health insurance plan has a program where if I go to a specific doctor’s office, I will only owe 10% coinsurance instead of 20%. BCBS confirmed my doctor’s office participates. Well the claims are being submitted as “X Pediatrics” instead of “X Family Practice.” The incorrect name they are submitting the claims under is not even at the same physical location as where my doctor’s office is located. The reps at BCBS are throwing it back on the doctors office saying they need to resubmit using a different tax ID #. What are my options if my doctors office refuses to do this? It seems like I can only appeal claims at BCBS if they are denied. It wasn’t denied, just wasn’t paid correctly. Would my State Dept of Insurance help me at all?
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