Help getting insurance to correct their mistake on my claims

2 months ago I visited an urgent care clinic twice in one week while on vacation. They were not in my network so I paid in full at the time. I later filed claims for both visits, checking the box on the claim form to have them issue payment to the subscriber (my husband) rather than to the provider.

Since then, each EOB I’ve received has shown partial coverage for these 2 claims. That’s great. However, each one has stated that payment was issued to the PROVIDER (instead of to me).

Each time I get one of these erroneous EOBs, I call my insurance. So far I’ve made 5 phone calls and wasted close to 3 hours on the phone with them. The details of each call have been slightly different, but they typically end with the agent assuring me that they will issue a stop payment and reissue the check to me. But like in Groundhog Day, the same mistake keeps happening. I just received yet another EOB with the same error today and will need to make yet another call.

I’ve tried contacting the provider’s billing office directly, but they never answer, and I haven’t yet received a call back. I’m very sick, and it takes so much energy to keep calling them (not to mention the stress it’s been causing me).

This isn’t exactly an appeal situation, since they haven’t denied coverage. They just keep sending payment to the provider instead of to me. I know patient advocate groups help with provider issues, but are there any organizations that help patients deal with insurance problems like this?

(I’ve had countless issues with this insurance company and would love to switch but it’s with my husband’s employer. In fact, there’s a second mistake I need to call them about this week. It’s really taking a huge toll on my health.)

submitted by /u/Few-Relation-4776
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