Received bill almost 3 years after service and provider never submitted a claim with insurance

Hi all, looking for some advice on what to push on.

My child was born and added to my insurance through Cigna. Cigna had a system error that changed the start effective date of the our coverage to the 3 months after my child was born. This was fixed months later after multiple headaches of working with Cigna and getting the hospital bills submitted correctly.

I just received a bill from the pediatrician after almost 3 years with a final notice stating they will send the bill to collections at the end of October. I am not looking to get out of paying my responsibility however insurance should cover 100% as I met my out of pocket maximum due to the hospital bills already from them.

I have now talked to both Cigna and the provider billing department and manager. The first conversation with Cigna I found out the provider never submitted a claim for any of the 3 visits. I talked to the provider and they admitted to never submitting a claim because my daughter didn't immediately show as covered in their portal. The provider refuses to resubmit the claim in fear that Cigna will reject it at which time the provider claims they will be liable for the full claim. Therefore, the provider wants Cigna to provide a letter stating they will accept the claim once submitted. I then spoke to Cigna and they will not provide a letter and directed me to submit an appeal in their system with all of the information and an explanation of why the provider has not submitted the claim.

I believe my options are as follows: 1. Pay the bill eat the cost 2. Pay the bill submit an appeal with the insurance, hope that forces the doctors to refund me 3. Play a game of chicken with the provider telling them to submit of the claim and do not pay the bill. Risk it going to collections and having to fight there 4. Jump through paperwork hell to get all of the documentation and submit an appeal for the provider in hopes Cigna will pay the provider correctly

Any other options and recommendations?

submitted by /u/Wigton761
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