I took my daughter to an urgent care center for kids. We've been there many times before with no problem. My insurance was billed correctly before and everything was covered.

I found out the urgent care center switched to 3rd party billing. The 3rd party billing is just using a flat rate procedure code: S9083 for insurance claims.

This code as part of the contractual agreement between the urgent care center and my insurance is not covered. The agreement is to use specific codes. For example my daughter had a step test so the procedure code for a strep test should be used.

As a result my last three visits going back to 2021 were denied. I received no communication from the urgent care center until three days ago. Apparently one visit is just forgotten (maybe too old?), the second I'm in collections over and the 3rd is the only one they sent communications regarding.

The 3rd party billing is like talking to a wall and they misrepresent everything they are telling me. My insurance has been cooperating and I know the above due to them telling me. For example, the 3rd party billing tells me urgent care isn't covered by my insurance. I've had other urgent care center services covered and my insurance confirmed urgent care services are covered.

Billing said they would resubmit the claim but using the same denied procedure code. I'm fighting them on this. Insurance says the resubmit with the S9083 code will be denied but submitting with correct codes will result in payment.

What can I do to get the 3rd party billing to resubmit the claim with the right codes?

Odd happenings but the billing agent asked me what the correct codes are. She would resubmit with the codes that I tell her. Thus for me is a red flag! Don't they have medical coders? This that fraud for me to just give her codes? Can I give her codes and get this settled? I'm lost, please help.

EDIT: I'm in IL and also looking for any state resources I can use to pursue this if need be.