Re: in network provider did not obtain preauth.
I posted here a few days ago re: an issue I’m having with an in network provider and got some helpful info, but both BCBS and my provider are telling me contradictory things. TL;DR: I am in a mental health program that requires preauthorization, my provider didn’t obtain it, and now both my insurance and my provider are telling me I’m on the hook for $1.9k per day of the program. This is a thrice weekly program that runs for twelve weeks. I can’t afford $68.4k of treatment, but nobody is budging on me owing for these denied claims. My provider says that they tried to obtain a preauth, but my insurance told them that it wasn’t necessary, so it’s my responsibility. My insurance is saying it’s necessary, but my provider failed to get it, so it’s my responsibility. Then, when I ask how to obtain a retroactive preauthorization, I’m put on a lengthy hold, which eventually kicks me back to the main automated menu. Yesterday, a rep at BCBS said they tried to call my provider but were sent to voicemail; when I called <90 seconds later, I got through without trouble. None of the reps at BCBS that I’ve been able to speak to are willing to do a three way call; they say I must speak to their preauthorization department and transfer me, but all I get is the aforementioned hold music. I’m really not sure what to do from here.
submitted by /u/lichprince
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