My job changed to Prevea 360 in January of this year. I get quarterly injections for birth control and have done so for years. The drug used is listed in the insurance company's documents as covered and is also protected under the ACA as preventative care which is covered pre-deductible. They've been a nightmare about it.
I just got a message from the clinic that I have a bill due and logged in to see that the insurance has rejected 100% of it for the 8th time. Every time before this I've called and they insist something different is wrong with the submission. First the codes were in the wrong order, next a checkbox was missed, then maybe some other checkbox. Every single submission they've found something small wrong in order to reject it. And they they suggested that maybe I should go to a bigger clinic that knows how to code (they're mad that they're being forced to cover Mayo clinic as an in-network hospital/clinic and want me to go to one of their own clinics instead).
At this point what do I do? It's been rejected 8 times for varying degrees of BS and they refuse to talk to the clinic directly about it.
submitted by /u/LaHawks