My policy is ending and I have an existing unprocessed medical claim

Hello,

I have been fighting tooth and nail with Excellus for 7 months now to get reimbursed for a medical claim I submitted in 2022. I went through the appeal and grievance process for the reason they denied it and they agreed to overturn. I was supposed to get reimbursed in January but then they denied the claim again for a new reason (not medically necessary). I had the surgery done internationally and my medical records only contained a summary of my medical history and did not contain a diagnosis code. Excellus conveniently assigned an inappropriate diagnosis code that made the claim ineligible for coverage. So now I'm going through the appeal process again.

I want to resign from my job in March and be done by April. So starting from today I would have my existing policy with Excellus for 2 more months.

What happens if the claim isn't finished processing and paid by then? Can they deny it altogether since I'm no longer a policy holder? Is there any way to have them expedite the process since it has been so long?

Thank you.

submitted by /u/IamLeeroyJenkins
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