I have health insurance through Blue Cross Blue Shield Montana. I had surgery back in september. The surgeon doesn’t deal with insurance companies at all, so I had to pay up front and submit a claim on my own for reimbursement. I did so, and sent it via certified mail, and they received it on november 22. I checked online today, and couldn’t find the claim on my account. I called, and the customer service guy had to do some digging, but eventually told me that the claim was missing one of the billing codes, they sent a letter to the surgeon asking for the code, and since the surgeon doesn’t deal with insurance, the office obviously didn’t respond. Since they didn’t get the codes, the insurance company “withdrew” my claim. I was never notified of this in any way. How can this be legal? If I hadn’t called, I would have no idea. If the customer service agent were less competent, I would still have no idea. Luckily, I still have plenty of time to file again, but I’m shocked that they’re allowed to do this. How am I supposed to submit a corrected claim if they don’t tell me it wasn’t done right? The guy I spoke to said that they wouldn’t send the letter stating the corrections needed to me, since I wouldn’t have the codes. Codes which I can get from my surgeon, but which he won’t send to the insurance company. If they denied the claim, then apparently they’d have to tell me, but they can just withdraw it instead and not tell me at all.
submitted by /u/Quo_Usque
[link] [comments]I have health insurance through Blue Cross Blue Shield Montana. I had surgery back in september. The surgeon doesn’t deal with insurance companies at all, so I had to pay up front and submit a claim on my own for reimbursement. I did so, and sent it via certified mail, and they received it on november 22. I checked online today, and couldn’t find the claim on my account. I called, and the customer service guy had to do some digging, but eventually told me that the claim was missing one of the billing codes, they sent a letter to the surgeon asking for the code, and since the surgeon doesn’t deal with insurance, the office obviously didn’t respond. Since they didn’t get the codes, the insurance company “withdrew” my claim. I was never notified of this in any way. How can this be legal? If I hadn’t called, I would have no idea. If the customer service agent were less competent, I would still have no idea. Luckily, I still have plenty of time to file again, but I’m shocked that they’re allowed to do this. How am I supposed to submit a corrected claim if they don’t tell me it wasn’t done right? The guy I spoke to said that they wouldn’t send the letter stating the corrections needed to me, since I wouldn’t have the codes. Codes which I can get from my surgeon, but which he won’t send to the insurance company. If they denied the claim, then apparently they’d have to tell me, but they can just withdraw it instead and not tell me at all. submitted by /u/Quo_Usque [link] [comments]Read Morer/HealthInsurance