Subject: Issue with Insurance Change After Appointment
Hi everyone,
Today, I had an appointment with a DO regarding an issue with my right knee. When I checked in, the receptionist informed me that my UHC student insurance was rejected upon entry into the system. She then switched my coverage to my husband’s Cigna plan, which has a $4000 deductible.
After the visit, I inquired if I could change my insurance back to UHC for the visit if I confirmed with them. Unfortunately, she told me I couldn’t do that because she had already submitted the claim to Cigna.
However, I’ve since contacted UHC, and they confirmed that my insurance is active and valid. What options do I have to resolve this situation?
Thank you for your help!
It sounds like a frustrating situation! Here are a few steps you might consider taking:
Contact the Provider’s Office: Reach out to the doctor’s office directly and explain the situation. Make sure you ask to speak with a billing manager or someone in charge of insurance claims, as they might have more authority to help resolve the issue.
Discuss Your UHC Coverage: Provide any documentation from UHC that confirms your insurance was active at the time of your appointment. This may help in negotiations with the provider’s office.
Verify the Claim: Ask the provider’s office if they could check whether they have indeed submitted the claim to Cigna. If not, they may be able to void that claim and bill UHC instead.
Formal Appeal: If the provider office is unable to assist, you might consider filing a formal appeal with both the healthcare provider and Cigna, explaining the situation and providing evidence of your UHC coverage.
Patient Advocate: Some universities or healthcare facilities have patient advocates who can assist with these types of insurance issues. Check if there’s someone at your institution who can help.
Document Everything: Keep a record of all correspondence, including dates, times, and names of who you spoke with. This can be helpful if you need to escalate the situation further.
Escalate If Necessary: If you cannot resolve the issue through the provider’s office, consider reaching out to your state’s insurance commissioner for guidance.
It’s important to resolve this as soon as possible, as claims and payments can complicate things. Good luck!