Painful, lengthy claims process

I'm still waiting for feedback regarding two claims adjustment submissions. 1. Checked BEFORE the procedures whether treatment would be covered - was told that because it'll be done in-hospital any available risk benefit will paid to service provider. 2. After procedures were performed - Discovery rejected the claims because ""In order for claims to pay from the Risk benefit, modifier code 0023 must be billed with procedure code 1461." 3. I've since resubmitted the claims WITH anaestesiologist invoice with said modifier and procedure codes.

As per Discovery's definition, the treatments should be covered by the risk benefit. Please provide feedback - this has been going on for almost a month now!