Does Insurance Ever Send The Wrong Letter (Denial)
Long story short: my son (under 1 year old) was evaluated for something recently and our clinic put in an authorization to insurance to cover it. 3 weeks later we get a call from the clinic claiming it was denied. I called the insurance and they said it wasn’t denied, but still pending. When I called the clinic back, they gave me the letter ID and person from insurance who sent the letter, with a few details in the letter. So I called insurance back armed with that ID. The CSR looked up the letter and confirmed our case but said it is still pending. He checked multiple systems and they all had the same status. Furthermore, he said the case worker isn’t even the person who the clinic told me. It’s someone completely different and nobody with that name had left even a single note on the file anywhere. He also said the letters he saw mentioned nothing about what the clinic told me.
He was completely dumbfounded on how a letter even was sent especially with someone’s name who is not even on the case. He suggested it could have been sent in error somehow, but he’d never seen it happen before.
Has this happened to anyone before? Curious how common this is. I work in software so I understand that there can be very weird hiccups that happen (rarely) in all kinds of software.
Please tell me this has happened to someone here before (if so, I’m sorry you went thru it).
