Insurance taking back coverage

Looking for advice on how to handle a situation with my insurance and clinic.

I had two IVF cycles done 10 and 7 months ago. Before these cycles, I was told by 2 separate representatives from my insurance that I was covered “100% up to 3 cycles.” I proceeded based on that. I was called a few months ago by my clinic saying that my insurance was now taking back the money they paid, and therefore I would need to pay.

History: Right as I was heading into the first cycle, my insurance sent a letter that they needed more information from my clinic to say I met their definition of infertility. I emailed the nursing team repeating the letter and asking what to do, and whether I had the prior authorization I seemed to need. I was told “your prior auths went through!” I thought that meant we were good to begin, but apparently that meant my prior auths for medications went through, not for the cycle…

Because we didn’t get any embryos from the cycle, we discussed doing another. But a denial letter came through from my insurance, and I wondered whether I was actually covered, so I asked the clinic billing department to confirm what they said I owed with insurance coverage was correct. They confirmed. I also asked whether they were able to do an appeal on the claim (which I think I was told to do because of the denial), and they said no they couldn’t since it was still open…

I thought that since billing confirmed that’s all I owed, even though the claim was open, it was ok. And because I had been told I was covered 100%, it was just a mixup about the denial, and again, because they paid it, it was ok. So cycle #2 happened.

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So, I get an email a few months ago from my clinic saying my insurance is taking back their payment. According to my clinic, they never received a denial letter and said they should have from the insurance. My insurance said they did send a letter and that when they received it, they should have stopped the cycle while they waited for appeal. A representative also said I shouldn’t have to pay because they didn’t stop. My insurance told me to file a complaint, to cite the two representatives who told me I was covered 100%, and to attach a letter of medical necessity from my doctor explaining why I should have those services covered.

I did file the complaint. It was denied. My clinic sent me a bill for the remaining portion of the first cycle. I’m sure this will happen with the second one too given the reasoning. What should I do?

Oh and we got 0 embryos from the 2nd cycle too! Yay us. 😭

TL:DR Clinic and insurance screwed up my coverage and I’m left having to pay for fees my insurance is retroactively denying coverage for.