Therapy claims being denied with Anthem HPN?

I am going to do my best to put it all the info here as detailed yet short to stick to the issue.

AGE 29 STATE NORTH CAROLINA STATE TAX I HAVE NO CLUE IM JUST A GIRL I WORK 38.5 HOURS A WEEK WITH $30 AN HOUR

I HOPE I PICKED THE RIGHT FLAIR LOL PLEASE ACCEPT THIS

Been on my employers insurance since August 2023.

I requested therapy with preferred provider under company. Found this provider on Psychology Today using my zip code and choosing Anthem and BCBS as insurance accepted. Company emails me April 22 asking to confirm my insurance and provider. April 23 company says they accept this insurance and verified it and I can have my initial appt on April 29. — shouldn’t they have proof of this? Both insurance and the therapy company?

Weekly sessions go on until June 8th then the company sends email saying all their claims have been denied (codes: 001 / 255) for them being an out of network provider. When I check my EOB, the 255 code was billed on 2 appointments, 001 on all the others denied. — shouldn’t I have known this within 30 days of my initial appt?

When the company sends me their denial for procedure 90837 (same as all of them), it has 277 HIPAA claim status code written with 585 – denied charge or non-covered charge. With $200 billed to me. At the top it has my name, my member ID , and “Product: InterPlan Program” — what is interplan program and why are these being denied on both ends?

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The confusion? ONE appointment was approved. On 5/11 it was approved. Right in between everything, nothing changed session or insurance wise.

I called. I’ve live chatted. Provider called. Company called. I emailed my employer. I have sent appeals for all the claims.

What do I do next? Do I submit an out of network claim myself?

submitted by /u/hanielnewastral
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