Legal Question in Health Care Law in Illinois

The rules of the plan should allow for dispute resolution. If you can not convince them (and you may need the help of a doctor to do so), you may have to hire an attorney to look into the matter and file some kind of legal procedure such as arbitration. You may be able to report them to the State Department of Insurance. Be careful with dispute resolution processes: they can limit you to a "binding" decision that can't be reviewed by a court.