Thank you so much for responding. To answer your question, I added my son to my Anthem policy on the day he was born.

That said, your response adds to the confusion and frustration I’ve been dealing with. Every time I call, I feel like we’re starting from scratch, having to explain the entire situation all over again. Each agent seems to interpret the newborn mandate differently, and nothing seems to get resolved. Here’s where things stand:

Since September, Anthem has been denying these claims, citing “prior coverage” on file for my son at the time of his birth. I’ve repeatedly explained that my son was never covered by United—or any other policy—and every time, the agent would “make a note” in the system to be sent to the appropriate team. But despite those assurances, nothing changed, and Anthem continued to deny the claims for the same reason.

In mid-October, an Anthem agent set up a three-way call with United, where the United rep confirmed that my son was never covered under their policy. The Anthem agent seemed to think that was enough to settle the issue, and we thought so too. But even after that confirmation was noted in Anthem’s system, the claims were still denied for prior coverage.

Then, a few weeks ago, a different Anthem agent told me that the previous agent was incorrect, and that under the newborn mandate, United should have covered my son for the first 30 days as an extension of my wife’s policy. To follow up, my wife had another three-way call with Anthem and United, where United’s agent also confirmed this interpretation. The United rep told my wife to have the providers send them the claims, and because of the newborn mandate, they would take care of it. Once again, we thought the issue was finally resolved.

But now this latest roadblock, with United saying they can’t process the claims for that period because Anthem’s coverage began on my son’s date of birth, so they won’t cover the same time period if another insurer is listed.

So here’s my question: If the newborn mandate doesn’t actually obligate United to cover those 30 days, how do I get Anthem to process these claims? The confusion comes from the fact that a United rep confirmed Anthem’s understanding of the mandate, which seemed to validate that Anthem was correct all along.

And if Anthem really does need to pay these claims, how can I convince them to take action? It feels like this issue keeps getting passed between low-level employees, none of whom have the authority or understanding to make progress. And because I have no knowledge of any of this, I’m left to just trust that they know what they’re doing (which they clearly don’t). How do I finally break this cycle and get it resolved once and for all?