Mistaken Identity & Submitted to my insurance
I have a very frustrating situation happening. About a week ago, I received notice of a claim my insurance denied from 2022…for a service I never had at a hospital thousands of miles away that I never was a patient of. My name and health insurance information were on the EOB with a provider I never went to, obviously.
It has been a back and forth nightmare dealing with this situation. At first I thought it could be medical identity fraud, but it turned out it isn’t.
My health insurance plan (Cigna) was totally useless – I called many times and used the chat to try to get some sort of guidance. They called the provider and called me back, saying the provider would look into it and call me back and that’s it. When I asked what happens after that, I got nothing.
After I finally got the hospital privacy director on this, she found that the billing department looked into it and it seems like the vendor that is used, Optum, to process the medical claims made a mistake and transposed my member number to that of a patient at their hospital with the same first name as me (not even last name, not even same date of birth, etc.).
Over a week later, and the medical claim still appears on my Cigna portal. I kept repeating to them that I need this claim off my record, as it appears the individual who got this imaging done has back issues (which I never have) and if I ever need my insurance record pulled in the future for life insurance for example, this might appear on there when I was not even that patient.
I am not really sure what to do at this point. Cigna says the hospital has to withdraw the claim, but then another rep said well it was denied so shrug. No one seems to get I need this totally off my record, as it wasn’t me who sought treatment. The billing department at the hospital is run by people just trying to cover themselves and they seem to be avoiding the calls of both myself and the insurance company.
Anyone ever experienced something like this? This is so bizarre and troubling. Thank you.
