Discovery as usual NOT paying VALID claim

Good Morning, we have been fighting with discovery medical for 4 months regarding an MRI, as per our plan it states that:<br> There is no benefit for MRI and CT scans done out-of-hospital, or for MRI and CT scans related to conservative back or neck treatment hospital admission<br> Since the treatment was for a SURGICAL procedure IE NON-CONSERVATIVE treatment, they are now trying to state that the procedure was not PMB related. Our plan allows for MRI's that ARE NOT PMB related as long as the MRI is not related to CONSERVATIVE Treatment. Our original codes for this were unfortunately messed up by Lake Smit, but have since been updated to reflect NON-CONSERVATIVE treatment IE Surgical. Seems Discovery are so desperate NOT to pay they are using excuses that are NOT VALID, they also requested I send a motivational letter as to WHY the MRI was needed - this was done too. THEN we were told that the motivational letter didn't reflect the correct codes. IT IS A LETTER you requested!!! I am tired of dealing with a ground level escalation clerk who has no foresight to actually look retrospectively into the claim as promised by Rishana Singh! I will keep posting till it is PAID!