Blue Shield denying claim, keeps saying my provider doesn’t have an NPI number

Sigh… I've been dealing with this for nearly two years now. I mailed superbills for several therapy visits back in early 2022. First, Blue Shield said they never received them, then later denied the claim based on not having any of my provider's information (despite everything — name, address, phone, tax id, NPI, and diagnosis codes being included on every superbill for every date of service). After about a year of griping that the info was incomplete, they settled on telling me that my provider's NPI wasn't valid. They've since re-reviewed and re-denied, gone through a grievance and denied, and I've appealed to the state board and got re-denied. My therapist has contacted them through the provider line and left multiple messages (over the course of several years), but whatever case agent is assigned at any point has never called her back.

I am also certain my therapist's NPI is real and works fine, because I have received reimbursement for more recent visits.

Does anyone have any advice as to where I can go from here? I have literally called Blue Shield at least 20 times already over the past year and a half, and I'm not quite sure what other option is available other than small claims.

submitted by /u/laserloris
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