Written response from my insurance – ("complex question" process) – how long?
A little over a week ago, I called my insurance asking them if they cover a certain procedure – they said yes! I then asked where I can find this information in writing – in the benefits booklet, or in any other source available to me. They told me that it isn't clearly addressed in any of these sources, and they were answering based on their internal materials. Given that I am exposing myself to paying quite a lot of money if this turns out to be wrong, I next asked whether there is a way for me to get to a written confirmation. She responded that yes, they have a process (called something like "complex question" process, and that she would put in my question in the queue to receive a written response, and to expect that response in "a couple of days". Three days later, I had not received anything, so I called back. The rep was able to see the details of the pervious phone call, and told me that there's no issue, that they just take up to 72 hours to respond. When I pointed out it had been just slightly under 72 hours, he backtracked and told me that he can't actually find how long it's supposed to take, but that he would expedite it. This last call was 5 days ago and I haven't heard anything since. Is someone familiar with this "complex question" written response process? Are there any deadlines or considerations on it? I should also add that my question wasn't actually complex (both the reps said it's simple; it's about whether my insurance will pay for therapy provided by someone holding a LMHCA license. Advise on how to proceed appreciated.
submitted by /u/Adventurous_Luck_269
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