Coverage discrepancy between provider and insurance

We have IBX as our main insurance and through IBX our vision part is David Vision. We are a family of four. We’ve been going to the same in-network provider for 8 years.

Last December I took both my boys for vision exams, this was the first time for my youngest. I get a call afterwards from provider saying my youngest is not showing covered and I have to pay for his visit. Older child was covered and good.

Confused, I go on both our IBX and Davis Vision portals and see all of us listed under there and shown as “Active”. I call back and tell them I don’t understand why they are seeing something else so they tell me they’ll try to call David Vision again. I also call David Vision, who was very unhelpful, other than confirming that we are covered and basically said this is a provider issue, not theirs.

I get a letter in the mail yesterday from provider, basically saying that they called Davis Vision and they could not find record of my son and being covered and I need to pay. (All the info they have for my son is correct, we double checked)

So I call Davis Vision AGAIN to confirm he is covered, they said yes, and gave me info for provider. I also called HR from work to help, they also confirm he is covered and gave me some info to give to provider.

I call back provider and give them this info to try. They say he is coming up under our account in their portal but they are unable to submit a claim for him for some reason (they say they can’t click on his name) so they will try to call Davis Vision to do the claim over the phone. I asked them to send a paper claim and they said they won’t do that.

Totally at a loss of what to do and what is going on!

submitted by /u/No_Panda_9171
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