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Health Care company falsely claimed provider was in-network
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During 2020 my insurance provider claimed multiple time, online and over the phone, that my pediatrician was in-network. I then proceeded to take my children to this pediatrician only to have my insurance deny the claims saying the provider is out of network. This means that the preventative care which should've been covered 100% was not and I'm now being billed $3,400 that I would not be required to pay if the provider was in-network as they claimed.

The insurance provider has been a pain to work with, I've been calling them about once a month for the past 15 months trying to figure out what's going on to first be told "yes, they're in-network, we just have a paperwork issue" to now being told "no they're not in-network". They were willing to adjust and cover just over $800 because they admit they made a mistake by saying the provider was in-network multiple times.

When I've tried to talk to them about the rest of the charges I get told they'll look into it and give me a call back. I've never gotten a call back or a response to my email.

I'm wondering what legal actions I can take or if I'm dependent on their mercy. I'm in Utah.

Edit: clarified insurance provider.

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3 years ago