Dental insurance claim taking too long, anyway to make it faster?

So I was laid off March of 2023 and signed for cobra right after so I could keep my benefits. Anyways, turns out that at some point, my benefits were never updated. So the insurance company just saw I was laid off and took me out the system. So I was making payments for my premium dental insurance until I was told that it wasn't even active. I made a call, they looked into it, and reactivated me for 2024.

Great, until I found out that I still had to pay my orthodontist for my aligners. However, the services were done during 2023 and not 2024, so the company never paid them out due to thinking I was never in the system. I called again and told them that I need to be updated for 2023. They then go on to say that I was not active for that year under the plan I need and if I needed to change my package, I would need to contact my old employer. So I did and they resend the same information to the Cobra company who then sends it to the insurance company.

After all that, the insurance company then needs to open an appeal to update my package from 2023 to the premium package while I still need to pay for my aligners. They initially told me it would take 30 days and there has been no change in that time. I called today and was told it would take 60. I asked to speak to a manager and explained the situation. How it doesn't make sense that I need to wait 60 days to have my insurance corrected when they entered me in to the wrong one and how I need it corrected so they can pay my orthodontist. They said they would call me back with an update on Friday which means I need to reschedule my appointment again since they will plan on billing me and I can't pay for 2023 services.

See also  Apta Health / Southern Scripts - any experiences?

At this point, I don't know what to do. It's literally as simple as reviewing the documentation, seeing they entered me into the wrong package, and updating. Maybe a few notes as to why the change in the system. I told them if it isn't fixed soon I'll file a complaint with the department of insurance in my state but not even sure if that would do much.

Any advice would help.

TLDR; laid off, signed up for cobra, insurance company messed up my dental package. Didn't have me active in the system, called, got it corrected. Then find out they have me on the wrong package, called again, said I need to appeal for the 2023 year. I do so, told 30 day wait time, not told 60. Spoke to manager, told I'll get a call Friday. Need to reschedule my Ortho appointment since they will bill me for services from 2023 that insurance was supposed to pay.

submitted by /u/CookieMonster37
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