Multiple issues
These are my issues
- information regarding covered providers is not kept up to date on the website which has caused benefit elevation claims to be filed that did not need to be. This delayed the care that I needed. It took about 30 BUSINESS days for them to let me know this was denied as unnecessary and that the provider is actually in network
-since I have to call them to find out if providers are in network- I did that regarding a provider in a dermatology office that other providers were in network - I was told the provider was in network but when I got the bill, it was billed as tier 2 - out of network- they stated that the wrong tax ID number was used - called the office - could not resolve- filed an appeal and it was denied- I submitted the appeal in Sept 2025 and never heard back- called multiple times- told multiple times they would reach out to appeals department- finally (April 2,2026) I was told that the appeal was denied and that I should receive a letter.
- I went to a tier 1 provider for care- I am an ascension employee - this is ascension insurance- they sent biopsies and excisions to Pathology Associates of St Thomas (st thomas is the name of the ascension facilities in middle tn) it was processed as out of network- I called and they stated that only one pathologist in that group is tier 1 and unfortunately she is not the one that handled the specimens
- the associates you talk to when calling in don’t know enough information to actually help- there is no way to get help without actually calling and when you call in, it takes an excessive amount of time to get an associate: basically it’s an exercise in frustration- then, they don’t stand by what they tell you and you can’t prove what they said since you have nothing in writing