Dental Insurance Company Did Not Provide Me Eobs For 6 Months. In Network Teaching School Billing Department Refuses To Give Me A Straight Answer About Why Claims Are Being Denied.

I am getting bounced between an insurance company and a billing department. Billing department seems to show up to work past 11 a.m when they are required to clock in at 8a.m at a teaching school. Their only mode of communication is to scream the same thing over and over without listening to the patient. Refuse to write emails back, call back, leave voicemails or take phone calls. Also seem to not respond to fax messages. I don't know how the teaching school is running with these people rarely being at work. They told me that my insurance denied my claims and its a bad insurance that never covers anything. When I asked for written proof the billing department person refused to provide me one (as to why the claim was denied).

They also proceeded with a medical procedure (nasty dental infection spreading to jaw, face and eyes) without getting proper preauthorization. Which I kind of needed but it would be nice if they had told me ahead of time. Meanwhile my insurance company's customer service told me that claims had been accepted only for them to deny the claims. They also hid the fact that these claims were denied by not showing them on the website until months later. They also offer EOBs online but the links do not work. When I requested EOBs in fax or e-mail they at first refused but then the parent company accepted to send the fax EOBs only for the faxes to never arrive.

I asked for the EOBs because the screaming college billing department lady wanted me to bring her EOBs before she was willing to give me even the most basic of information as to why the claims were denied. Insurance company claims that the billing department is aware of all these things and is just being incompetent, lazy or deceptive.

Here's the thing. By law these companies are required to give out EOBs within 30 days? I have claims going 7 months that don't have their EOBs accessible. They also lie about faxing them. So I am certain that their mailed EOBs never arrive either. I think that is illegal? can I sue them for that?

Insurance lady not communicating properly, not showing up to work, not sharing why a claim is denied in a written format or perhaps verbal but clear and concice; it is delaying treatment, furthering harm done to my body and its costing me hours and hours sitting on the phone that I could be working for a living.

Can I sue the insurance company for doing illegal things? is it even illegal to lie and hide EOBs? can I sue the billing department people for avoiding contact with patients and just doing the bare amount of work when they are required by their contract with insurance companies to do much more? all of this after going to a teaching school.

I respect health professionals. I have only had good experiences with health insurance companies in the past. There are many good people there. But I got roped into this insurance as my main insurance plan switched their dental providers (I was not aware). And I guess the staff members at the university billing department have changed in the last few years. But the current situation is nothing short of a scam.