Ha, I know Carelon! It's their pharmacy division for specialty (read: expensive) medication. Not a clue as to why they'd be involved in a CPAP claim, but this story does ring far too close to home.
I once spent months fighting United Healthcare to stop hounding me for a $2k bill that I categorically did not owe. Countless phone reps were unable to remove it from my account; I only solved the problem by making a big enough stink on Twitter for someone from corporate to get involved. Good times!
Carelon also does preauthorizations for various expensive procedures and such. I’ve had the displeasure of having to try to coordinate between my insurance provider and PCP’s insurance coordinator for authorizing some expensive blood tests. Insurance wanted the PCP to use Carelon, Carelon automatically denied it, the appeals process was designed to be as frustrating and opaque as possible.
(Unlike the OP, I didn’t have the patience to spend two years navigating the kafkaesque nightmare they did. I finally gave up after a couple months of being stonewalled by all the parties who would refuse to talk to one another and me trying to be the middle man. I never did get the blood work done. So much for preventative medicine.)
I once spent months fighting United Healthcare to stop hounding me for a $2k bill that I categorically did not owe. Countless phone reps were unable to remove it from my account; I only solved the problem by making a big enough stink on Twitter for someone from corporate to get involved. Good times!