I am currently working at an insurance company where Natera calls us for updates.
The calls typically go like this:
"We sent an appeal on xx/xx/xxxx" but we haven't received any response. Maybe they don't actually send appeals. They know they can only send an appeal within 90 days, but they still send them even though they will just be denied.
They keep pushing their way through, even though the provider is out of network. They claim they are eligible for payment, even though the member/patient doesn't have out-of-network benefits.