Insurance won’t pay claim

Initial claim was denied. Won on appeal with help of lawyer. Had doctorrefile Claim as requested. Not sure why as they had all the info. from initial claim. Doctor says they paid it, reversed it, paid and reversed again. I have spoke with doctors several times and begged them for one person to make it their business to resolve this issue. They said ok, so I don’t keep calling and starting over and over.

I also discovered two additional treatments I overlooked and asked doctor to file a claim for the de as well.

Twice I have called to follow up and no return call

I spoke with insurance co. and they said doctor reversed the initial claim due to an error but never refiles. Secondly, the told me they never filed initial claims last year for the additional claims as I paid out of pocket for all, insurance company says they will not pay two additional claims because too much time has passed and they never filed initial claims for them.

Doctor said we will refund you for initial procedure???? And nothing on the other Two. Because they failed to initially file I have no way of getting any money back on them

What do I do? I can file a formal complaint with the office of patient relations.

Thank you.

submitted by /u/Remarkable-World-234
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