Medicaid denied claim, do I now owe $200?

Hey, so recently I started seeing a new therapist. She billed my insurance, (Molina) $200 for her services. Today I got a letter from Molina saying they denied the claim according to my IMC Apple Health Adult plan benefits. I can file a grievance if I want. I’m now freaking out because I don’t have $200 at all, what should I do?

In the letter, it says, “The claim was denied due to benefit maximum for this time period or occurrence being reached.” The procedure was billed as 90791 Psychiatric Diagnostic Evaluation which is weird, since I never received a psychiatry evaluation, only therapy.

I have no idea why the claim was denied since this therapist said she accepts my insurance. I also want to stop seeing her and I don’t know if that will complicate things or not with this claim denial. I plan on calling Molina’s member services tomorrow as well as this therapist but I’m kind of unsure what to say besides, “This claim was denied and I can’t afford $200.”

I’m currently freaking out as I’m broke and have no idea how to make $200 quickly.

submitted by /u/spazthejam43
[comments]