Claims Incorrectly Processed – Appeal Letter

I have a couple of questions about a situation that has been going on for longer than a year now. I left my place of employment and elected to continue paying for the coverage with cobra.

Long story short, I didn’t realize that I needed to submit my primary insurance first showing that they wouldn’t cover anything, so that my secondary insurance, the one that I’m paying for with cobra, would pick everything else up.

So I have one year and five months worth of claims for twice a week, psychotherapy and medication management, and some of the claims have been processed correctly and paid, and some of them weren’t. I’ve been going through about a year and some going back-and-forth with them that they have lost the EOB’s for the other insurance, and every other excuse under the sun. They have now begun to process claims using a different year’s coverage for the plan.

Bottom line is, I wrote out the appeal letter, wrote out the timeline of all of the people I spoke with along the way, wrote all the dates that were incorrectly calculated…

Do I just ask for a review? Is there some magic word that I should ask for?

Is there something I can ask for that will detail the exact plan information? I asked for a booklet from the specific years that I have claims from and they sent me one, but it has the information from a different more recent plan year which doesn’t match what I had before.

Lastly, I’ve played this game with them many times where I’ve sent in claims via snail mail (this is before there was an electronic option), and even with the electronic option, they claim to have not received things.

I have sent things by registered mail and have received the signature back and they still have claimed that they haven’t received whatever I’ve sent them by snail mail.

The appeal information on the back of the EOB only gives a physical address to send a snail mail letter to.

Thanks in advance!!