Hi there,
Not sure if this is the proper subreddit (and I’m happy to post somewhere else if needed), but we’re at a loss. My partner received some neuropsychological testing (specifically for ADHD and ASD). When her psychologist sent in a referral to the agency that did the testing, we were informed that they’d schedule with us after confirming with our insurance (Cigna) that they could provide the testing.
An appointment was schedule, my partner attended, and then we received the EoB and bill. The insurance is stating that the service, even though it was performed by a psychologist who has a behavioral health contract with the insurance, is billed under a medical service, rather than a behavioral health service. Since the provider does not have a medical contract with the insurance, it’s charging as out of network.
Our frustration rests in the statements from the provider that they received authorization from the insurance. They also confirmed that their providers are all contracted with our insurance, but didn’t have information regarding behavioral health/medical contracts. The provider stated that the specific services in question were “neuropsychological testing.”
After that call with the provider, I called the insurance again and spoke with a benefits representative. That representative informed us that neuropsychological testing was a behavioral health service, which is in conflict with how the claim was processed.
We’re fully at a loss on how to proceed, as the services total $1,300 that we did not expect to pay. Is there any recourse or area we could pursue here? Is there some insurance equivalent to the FCC where a complaint could be filed?
We’re in Arizona.
submitted by /u/KazooOfTime
[link] [comments]Hi there, Not sure if this is the proper subreddit (and I’m happy to post somewhere else if needed), but we’re at a loss. My partner received some neuropsychological testing (specifically for ADHD and ASD). When her psychologist sent in a referral to the agency that did the testing, we were informed that they’d schedule with us after confirming with our insurance (Cigna) that they could provide the testing. An appointment was schedule, my partner attended, and then we received the EoB and bill. The insurance is stating that the service, even though it was performed by a psychologist who has a behavioral health contract with the insurance, is billed under a medical service, rather than a behavioral health service. Since the provider does not have a medical contract with the insurance, it’s charging as out of network. Our frustration rests in the statements from the provider that they received authorization from the insurance. They also confirmed that their providers are all contracted with our insurance, but didn’t have information regarding behavioral health/medical contracts. The provider stated that the specific services in question were “neuropsychological testing.” After that call with the provider, I called the insurance again and spoke with a benefits representative. That representative informed us that neuropsychological testing was a behavioral health service, which is in conflict with how the claim was processed. We’re fully at a loss on how to proceed, as the services total $1,300 that we did not expect to pay. Is there any recourse or area we could pursue here? Is there some insurance equivalent to the FCC where a complaint could be filed? We’re in Arizona. submitted by /u/KazooOfTime [link] [comments]Read Morer/HealthInsurance