Complaint Rating:

Company information:
1007 Dorothy St NE, 87112
Albuquerque, New Mexico
United States
Phone: 505-296-0036

I brought my son to a clinic specified as "IN NETWORK" by SRC for stitches after an accident. This was in February of 2009. It is now November of 2009. SRC has denied my claim 5 times in the past nine months. The following is a list of SRC's excuses for not honoring this claim, and my responses, in chronological order:

1. Your son is not a beneficiary on your policy - Not true, he always has been.

2. You have exceeded your annual cap for benefits - Not true, my annual cap is $2500. At the time of this excuse I had made only this one claim against my benefits.

3. The billing clinic used the wrong billing codes - Not true, checked with the clinic, engaged in a 3-way phone call with the clinic rep and an insurance co rep, which resulted in num 4.

4. I have no idea why your claim is being denied, I will send it back through underwriting but it may take a month or two to straighten this out - denied again.

5. And I quote "Visit codes are not payable when they fall within the service interval for the global code." - When I asked for an explaination of this, they could find nobody working there that knows what this means. Nobody.

Now, as of last week, they have agreed to pay a small portion of THEIR bill, citing that the clinic I took my son to is "OUT OF NETWORK", which is a baldface lie. They are also trying to charge me a deductible, which I have not yet disproved, but will.