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Subject:  Re: OON Health Insurance claim submitted too lat Date:  1/29/2020  12:11 PM
Author:  DeltaOne81 Number:  18194 of 18234

Well I spoke to the insurance company first. The woman I spoke to was very sympathetic and reached out to the doctor’s office. Apparently the doctors office claimed they did file on time but IMHO that was probably only the claim for the initial consultation not the procedure. But they were going to send proof so we will see.

Another thing I found was apparently he is in network on their dental network, but not on their medical network. Of course: 1) the app doesn’t tell you that, 2) when you go to a dental provider for an issue in your mouth, how would you know it’s going to be a medical and not dental claim?

So she also said she would escalate it to get it approved as in network. Of course if it’s in network but still late, that doesn’t help much.

So she said she’d work on it and get back to me in a week.

Last recourse would be I’d like to know what the network rate for those codes are and negotiate from there instead of full price.

... we shall see...
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