Reporting an insurance company when it’s a Medicare advantage plan?

Full disclosure, I work for the billing office for a large practice, and am purposefully going to be vague for privacy purposes.

A large and well known insurance company (Parent Company) made their subsidiary (Local Company) pay for my patients claims, even though claims were electronically submitted to the Parent Company and i have the billing proof that it did go to the Parent Company. Parent company sent claim to Local Company, and Local Company paid. Well come 360 days later, Local Company realizes and recouped it (which naturally it wasn't their patient to need to pay), and the original Parent Company has not responded in a timely fashion to have my claims reprocessed and paid (it has been 3 months since this began). The plan for this patient was a Medicare advantage plan. I would think I need to submit a report/file complaint with CMS, or should I go to the DOI first?

submitted by /u/HearingAidThrowaways
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