Anthem BCBC NH

Female, 29 y/o, 84k income – health insurance supplied by employer

Have people been having a problem with Anthem not covering visits for mental health care and specialty office visits that are supposed to have a co pay that deductible DOES NOT apply to? According to my EOB document that I have access to in my anthem Sydney account, specialty office visits are $60 copay, deductible not applicable and my therapy (mental health benefit) is supposed to be $20 copay, deductible not applicable. However anthem is not paying out, and except the “plan discount” I get for apparently having insurance, I am billed the full amount for these visits. I spent an hour on the phone with them yesterday and the specialty ortho visit they won’t pay for was billed “99203 – Office/outpatient Visit New”. The woman I spoke to tried to tell me the services rendered did not fall under specialty, but she agreed that ortho is a specialty. So I’m really confused as to how this particular visit is not covered?

I’ve also been to urgent care twice for flu like symptoms. I have a $100 copay, deductible does not apply, for urgent care visits but I just got two huge bills because insurance didn’t cover anything. The bills are mostly for the lab test ($125 each for a flu test) and $500+ for a chest x-ray. Are these charges not considered part of the urgent care visits? And also what the heck is my copay going towards??

I’m so frustrated if anyone could please help me understand I would greatly appreciate it

submitted by /u/Ok-Captain9750
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