AmyW_37625
New member
Hello,
Anyone have issues with BCBSIL Self-Payor Insurance not paying half the claims? They keep requesting the medical record for about half the claims. I appealed with the Administrative Simplification Rule, which they ignored. They are also finding any reason to not pay claims. First they denied for timely, I proved that wrong, so they then denied the same claims wanting medical records. The patient already has authorizations for these services. These are for ABA Behavioral Health claims. I filed a complaint to the DOL EBSA, but they said the patient has to file the claim. It is getting very frustrating. Any ideas are appreciated.
Anyone have issues with BCBSIL Self-Payor Insurance not paying half the claims? They keep requesting the medical record for about half the claims. I appealed with the Administrative Simplification Rule, which they ignored. They are also finding any reason to not pay claims. First they denied for timely, I proved that wrong, so they then denied the same claims wanting medical records. The patient already has authorizations for these services. These are for ABA Behavioral Health claims. I filed a complaint to the DOL EBSA, but they said the patient has to file the claim. It is getting very frustrating. Any ideas are appreciated.
