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Health Insurer Denying And Retracting Payment On Valid Claims.

Location: NH, USA. The insurance company is the Florida division of Blue Cross Blue Shield.

My employer provided health insurer (BCBS Florida) has denied a bunch of claims. When I called, they said it was because I have another insurance. I told them I do not and they just said ok we'll reprocess everything, it'll take a month. Nothing actually happened, and new claims continue to have the same problem. One claim did get fixed, but there are like 20 of them now. Every time this happens I have to call the provider, verify why, call the insurer, have them reprocess, and check back with the provider. It's becoming a massive time sink and I have a sea of random stuff in collections now because of this. Thousands of dollars.

There should be no reason they think I have another insurance. Same job nothing has changed in years. It stinks heavily of a tactic to just deny claims at random and hope they go away. The claims are all common 40 year old stuff, no accidents. Some were even paid, then retracted, which makes figuring out whats going on even hard and take longer.

What's the likely outcome if I sue them? Is there such a thing as sending them a notice that I intend to litigate if they do not immediately remedy the situation, and if so is there even a chance that would work? This is all stuff that my policy very clearly covers and I'm about to loose it if I have to call them one more time.

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Health Insurer Denying And Retracting Payment On Valid Claims.

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