nsurance claim help – multiple authorizations, mutiple denials – insurance says I’m covered

Hi, I was hoping someone could share their wisdom and recommendations.

Long story short – we had a healthy baby through a C-section a couple of months ago. Most medical claims have come through without a problem. However, the Obgyn that operated, the anesthesiology, and another doctor that performed – it has all been denied – while all being in network.

I have called the insurance multiple times, and their explanation is that the procedure is covered, but the doctors must submit the correct documents. I was able to collect that initially, an observation authorization had been granted, which made no sense, as we were there for a baby delivery. That was corrected with a another authorization, and something about code being inpatient, instead of outpatient. Insurance says that’s how the hospital bills were covered.

The Obgyn’s office has submitted four different claims, with all the different authorizations that had been granted, and they are still being denied. Obgyn’s office even explained that they have their own materninty authorization and that the insurance is wrong. So, we are caught in the middle of this…

Should I just wait for all of the doctors to send me an actual bill and fill out the forms? Should I do something else? I have recorded the dates, times, and insurance reps I have spoken with each time.

Is there an online service anyone would recommend, I guess like healthlock, but that does actual claim submission help?

submitted by /u/Ac4m2
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