PCP & Specialist giving false information

My mom had to see an acupuncturist and requested a referral from PCP as she has HMO health plan. PCP mentioned she doesn’t need a referral for acupuncturist. Then I called the specialist and they “checked” her plan and she does not need a referral. She visited the acupuncturist office twice. After her second treatment was done, the doctor/rep told her “Your insurance did not cover the first treatment. You have to pay in cash.” They waited till her second treatment was done to let her know.

I called the health insurance and they said it is covered 100% but we will need a referral from our PCP and it is not too late to request it. PCP wrote us a referral but they did not backdate. I called the acupuncturist and told them to file a claim so they refunded. After 2 months, they finally filed the claim. It’s still in Anthem’s court but they said it will probably defer to the medical group. I’m not sure if it will be an issue since we received a referral after the care and maybe it was better off paying cash? Very disappointed that I could not get a clear answer from any of these people when asked prior. What are my options?

submitted by /u/nansheep2
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