Edit: *Provider
So I am in a bit of an odd situation. I have been seeing an OCD specialist for a little over a year. He wasn’t always the best at communication, but he was extremely helpful in our sessions and I learned a lot, so I stuck with him. He was out of network, but I got approval from Aetna to use in-network pricing. I pay full price upfront and then submit a claim and get reimbursed.
Back in July my insurance ended because I changed jobs. I submitted my claim as usual for my June sessions and I was denied. After several weeks of back and forth calls and emails, I was told I need various documents from my provider. I never needed that before, but I got the usual “policy changing blah blah.” I reached out to my provider and was told to wait a few days and he will get it to me. Some time went by and nothing happened, so I followed up and apparently his office was supposed to mail it out but I never received it. He said he would look into it and get it in the mail.
I eventually decided to stop seeing him because I need someone who is more reliable. However, I still have not gotten this paperwork. I have been calling and emailing him and cannot get ahold of him at all. My time frame for submitting this claim is about to end and I am not sure what I can do. Aetna won’t reimburse me without that paperwork and I can’t get that because he is not answering.
Does anyone have any advice for what can be done in this situation? I am at a total loss at this point.
submitted by /u/fictitiouseli
[link] [comments]Edit: *Provider So I am in a bit of an odd situation. I have been seeing an OCD specialist for a little over a year. He wasn’t always the best at communication, but he was extremely helpful in our sessions and I learned a lot, so I stuck with him. He was out of network, but I got approval from Aetna to use in-network pricing. I pay full price upfront and then submit a claim and get reimbursed. Back in July my insurance ended because I changed jobs. I submitted my claim as usual for my June sessions and I was denied. After several weeks of back and forth calls and emails, I was told I need various documents from my provider. I never needed that before, but I got the usual “policy changing blah blah.” I reached out to my provider and was told to wait a few days and he will get it to me. Some time went by and nothing happened, so I followed up and apparently his office was supposed to mail it out but I never received it. He said he would look into it and get it in the mail. I eventually decided to stop seeing him because I need someone who is more reliable. However, I still have not gotten this paperwork. I have been calling and emailing him and cannot get ahold of him at all. My time frame for submitting this claim is about to end and I am not sure what I can do. Aetna won’t reimburse me without that paperwork and I can’t get that because he is not answering. Does anyone have any advice for what can be done in this situation? I am at a total loss at this point. submitted by /u/fictitiouseli [link] [comments]Read Morer/HealthInsurance