Told in-network, actually out-of-network. Insurance company reimbursed wrong entity and now I cannot get the money back. Where can I report them to?
Very long story so I'll really try to cut it down to pertinent information. For professional school I was required in 2021 to get the pre-exposure prophylactic rabies vaccination. I was told by my insurance company that it is covered 100% if I file it medically and not pharmaceutically, if I get it done at x pharmacy. This has been confirmed on 3 separate occasions by 3 separate insurance representatives/supervisors.
My insurance company deemed x pharmacy out of network due to an obscure reason (the parent company is in network, but I guess the partner company is not or something?), and therefore I can only be reimbursed 50%. They proceeded to incorrectly reimbursed x pharmacy the 50%. They are unable to get the money back to reimburse me due to "contractual agreements." I have been in contact with x pharmacy (although they rarely respond) and have been waiting to get my 50% back from them for almost a year. My insurance company also has no intentions of reimbursing me the other 50%, after internal appeal and external appeal. I was advised to file a complaint with the Better Business Bureau about x company by my insurance company. I have been told that the BBB is bull so I'm not confident this will help at all.
My question for you all lovely people is what is the best next course of action for me?
Should I file a complaint with the BBB against both my insurance company and pharmacy x? Would legal action be helpful in any way shape or form against 2 massive companies with very strong legal defenses? Should I report my insurance company for fraud ? How could I even go about doing this?
submitted by /u/Throwaway2398742
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