Out of Network Benefits not Paid??

I need some help from anyone who understands Aetna reimbursement for out of network services. This is NOT asking for medical or legal advice.

I had my deviated septum repaired by an out of network doctor on 5/4/2023. Prior to the surgery, I confirmed my out of network benefits would reimburse me 55% of what I spent with an Aetna support agent. I faxed the paperwork in on 5/5/2023 but no one in Aetna "sent it in".

On 5/15 I chatted with an agent to submit. On 5/25/2023 I reached out to Aetna, no update. I reached out via chat today and the agent said the documents are "illegible". They were documents printed and scanned via a fax app and the "sent" fax shows perfectly legible. Also, they never communicated this to me to allow me to resubmit. I know insurance companies don't want to pay out, what do I need to do to get Aetna to reimburse me??

Any/all advice would be great!

submitted by /u/cinnamon23
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