I am trying to help my niece get this company to pay her claims. They have a real knack for not paying/stalling on payments with unwarranted excuses (i.E. Person has another insurance; billing code is not correct; expense is not reimbursable;/and making it very difficult to talk to someone. I have been on the phone with them for hours and still not resolved anything. They say after being given certain info (again) they will re-submit the claim. But nothing changes.
I am not a medical billing expert, and this is such a mess I'm not even sure where to begin. It has been almost a year since this started and bills are going into collection. My niece originally went into the hospital because of some mental health issues, complicated with alchohol abuse. So she is simply not able to cope with this kind of run-a-round.in fact, it has exasperated the circumstances considerably, hence, why I am trying to help.
After doing some internet research, I have found many complaints about this company for various reasons. They made the state of California so mad, it put out a "cease and desist" order on them.
I would just like to get some help in how to fight them. Like I said, it is such a mess with so many bills. And their Explanation of Benefits do not seem at all easy to understand. I know I'm not a professional billing expert, but we personally have Blue Cross/Blue Shield insurance and I've never had a problem figuring out their system.
Please, if anyone has any idea as to what we can do next, I'd appreciate it.
Thank you in advance.
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