Blue Cross keeps asking for documentation which does not exist
Hello,
My mother recently underwent treatment for breast cancer. She's a federal employee insured via Blue Cross/Blue Shield — FEP Blue.
She paid $16k for radiation therapy, which is covered without a need for prior authorization per the terms of the program.
The insurer has not yet refused to pay the claim, and instead has spent the past year asking for documentation which does not exist. This includes:
-Asking for doctor's notes which were never created
-Asking for information about a date on which no treatment was claimed
The result of this has been more than a year of back-and-forth with no payment of the claim, and no denial that we can appeal. The insurance company representatives aren't questioning the treatment itself; rather, they keep delaying reimbursement by repeatedly asking for information which does not exist. We've been on the phone with them regularly about this over the past year; today, FEP Blue told us that they have no record of our correspondence about this issue.
Do you have any advice on how best to proceed to resolve this?
submitted by /u/Bongobhondu
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