Chiropractor is not willing to refunded me, excuse me?

This is my original story.

Why doctor doesn’t submit my claim?
byu/No_Syllabub_4536 inHealthInsurance

In short, I visited this chiropractor on December 1st, 2022. She asked me to pay $260 upfront first and after the insurance came through, she would refund me so I did so.

Finally, I see my claims on the website. The explanation of benefit is:

Bill by provider: $260

My Health Plan’s Discount: $193.79

My Health Plan Paid: $21.21

My Cost: $45

The items were:

Patient visit: $120

4 X-rays: $140

The chiropractor says that because the insurance company only paid her back $21.21, she can only refund me $21.21.

So I called the insurance company and they told me that the chiropractor didn’t submit the prior-authorization. Luckily, I didn’t sign the waiver.

So what should I do next?

(I also Googled this chiropractor and found out that she and her husband were sued by an insurance company for submitting false claims a decade ago.)

See also  Governor Lamont and Access Health CT Announce Launch of Broker Academy, Aiming To Reduce Health Disparities and the Number of Uninsured - CT.gov