Self pay while processing appeals?

My wife recently had a transplant due to cancer, and as a result she has needed a lot of services. While fortunately 97 percent has gone well (insurance has paid over 600K so far this year), the other 3 percent has resulted in approx 10K of denied medical bills with more likely to follow. BCBS has denied paying for services that are clearly medically necessary, but it takes forever to go through the appeal process. One provider has offered a 50 percent discount if I switch to self pay. Should I do this self pay amount while I pursue appeals? Or does self pay limit my ability to appeal and get recovery through the insurance?

The provider mentioned once the bill goes to collection in a few months there is no way to do a reduction for self pay, so I’m wondering if I’m better off paying a reduced amount now while I continue to fight it, or if going self pay eliminates my ability to appeal and get recovery later.

As an overview of the absurdity, denials have included blood transfusions (necessary for her to stay alive) and testing denials to see the status/health of her transplant, likely due to some coding issues in the system that I’m having difficulty getting the provider to resolve with BCBS despite multiple attempts.

As a side note it’s so frustrating to me insurance pays often 10 percent of the billed amount on average for some of these tests but I’m stuck with 100 percent because they refuse to pay anything. This wouldn’t be such a big deal if I could pay the insurance rate as a self pay.

See also  Cigna insurance did not cover my lab tests

submitted by /u/StarFire82