Claim denied even though insurance agents keep telling me it should be covered

I am under my dad’s insurance Aetna with his work. I have seen this provider (psychotherapist) for many years and my plan has always been covered. This year, the first set of appointments she billed me for was covered. However the second set of appointments was denied.

I called about three months ago and they said it should be covered and they resubmitted it. Kept calling and a month later one agent told me that my therapist hadn’t put a diagnostic code on the claim and so they called my provider and asked her for it. The agent said she would escalate the claim.

This is was a month and a half ago. I called them 10 days later and another agent said that there was no way it would have been escalated and that it was going through normal processes. So the previous agent had lied to me.

I call today and I’m still getting the runaround. Every time, the agent assures me that it should be covered (and I would only pay 10% of what the denied price is) but that they don’t know what to do about it. Please advise! I’m so lost here.

submitted by /u/paisleyboxes
[comments]