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My health insurer's claims system is broken
2 points by bix6 on June 18, 2023 | hide | past | favorite | 1 comment
I have been trying to get covered out of pocket claims resolved for almost 6 months now but every time I call there is some issue that results in another 30 days of review. My doctor and I have both submitted the requested information multiple times but the phone reps say it was never submitted when we call in. My online portal shows the same claim 4 separate times with 4 different amounts listed for patient responsibility. I have another set of 2 claims of the same type where 1 shows the correct amount I owe while the other shows an incorrect number. It's clear to me that their system is horribly broken and I feel powerless. I have submitted a grievance but don't expect it will do much. Are there any other avenues available for resolution? Has anyone else had similar issues?


If your plan is through your employer, see if your employer offers an appeals process.




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