Untimely filing denial due to provider’s having incorrect info, advice on self-appeal?
I went for a medical checkup last November. I had recently changed my insurance but forgot to update my PCP. After the service I was billed around $1000, and call the provider to provide my new insurance information. I am a foreigner so due to complications in how my name is represented, I also emailed them my passport to change my name with the provider to match with insurance info. They told me to stay still and not pay the cost while they work with insurance. It came back denied around January, and I found out they changed the name wrong, so we went back and forth for another name change. It came back denied again in April, and after digging more I learn that the insurance number they have was missing one digit.
Now the claim is routed to the right insurance number, but the claim is denied due to untimely filing. The provider refused to file an appeal for me claiming they reached out to me multiple times and I did not fix it (they did not, I reach out most of the time to check and everytime they call I make sure to respond and work on the name change since I thought that was the problem). They also provide almost no communication, I only learned claim was denied after checking my insurance portal. I don't even have an EOB since they file it for me, and the provider never provide me with anything (no claim notice, no notice that claim is denied), just a bill. They even said on the bill that insurance covered a small amount, leading me to think initially the claim process was approved.
Can anyone please give me advice on filing the timely filing appeal by myself? I have the call history showing the original call when I give them my insurance right after I got my bill, call histories of back-and-forth for name change. I also have email in November of when I work on name change with them, and an email where I told them they have the wrong insurance number. I don't have the claim details for the first claim they file (within time and denied/rejected due to wrong number/name), and I don't even know if I call they will give it to me (they are extremely rude/clueless everytime I call).
submitted by /u/ElasticRoot
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