Humana
P.O. Box 14546
Lexington KY 40512-4610
Sept. 2, 2009
Dear Humana,
I recently took my daughter to a doctor in our neighborhood. I took special care to make sure this doctor was a “participating provider,” because I know how important that is to you.
(I made the mistake of going to a “non participating provider” once before and I got stuck with the bill. You can’t say I don’t learn from my mistakes.)
In the course of this visit she had some blood work done. This was mailed away to Tamarac Medical in Colorado for processing. Unfortunately Tamarac Medical is a “non participating provider” and so once again I am getting stuck with the bill, $40.00 in this case.
Note that I was not given any choice over where my daughter’s blood was sent, nor was I informed at the time that a “non participating provider” would be entering into the picture.
Therefore I humbly entreat you to reconsider this judgment against me.
Hopefully,
PS: Your claim summary specifies August 28 as the “Paid” date for this claim. Given the fact that Humana has not in fact “paid” anything for this service, don’t you feel that terminology is a bit confusing?
(In Humana)
I have Humana too and if its someone not on the list they are not paying. That list never seems to grow either. It’s your American freedom to have this great private insurance that will only cover participating providers.
Give ’em hell, B!
I’m going home to check my policy because I had to pay $95 for bloodwork, and it never occurred to me maybe it was because it was sent to a lab out-of-state.
B, quit giving Humana such a hard time; you could be up in Canada! For instance, Nicole’s mom turns 75 tomorrow, and I’ve got to drive her to the Death Panel! That is a long drive and way more inconvenient than a couple of letters. But no time to chat–I’ve got some soilent green on the stove. (I only get vegetarian soilent green.)
Be sure to send this to Larry C.
Sure does seem like a slimy, scammy way to deceive.
David:
Canadians – just like us, only better death panels (all apologies to Michael Moore!).
This is all on Humana. They should have arrangements with their PPO members to ensure that they only use participating providers for testing, or at least disclose that they don’t. Hopefully they’ll resolve the situation.
Better than the $1000 I had to pay for blood work to check on testosterone levels. Our insurance provider calls it “sexual” work and they do not cover anything relating to it.
The bureaucracy of managed care is unbelievable. The managed care entity (Humana in this case) expects clerks in hospitals to remember and counsel members as to whether a lab or a other supportive care depts are on their plans. Can you imagine how impossible this is with all the insurance co’s out there? Believe me, I know from years of experience. The medical insurance industry & their requirements in this country is a web of craziness for healthcare providers. Death panels? They’ve been in existence since managed care began.
As far as “reasonable and customary” goes ( as I read in your previous post) – it’s a term that insurance co’s use to try to get out of paying healthcare providers the local mean of reimbursement for whatever in the area. Unfortunately, consumers don’t know this & think their doctors are over-charging. I used to tell patient’s who complained about R&C to call other specialists/hospitals in our area & compare fees.
As you can see, this is an issue I am passionate about.
Peace.
This happened to me too! I had some bloodwork done while I was pregnant and it was sent to Boston. The Humana representative argued that I went to Boston at 38 weeks. I hadn’t even left town. I WISH I had a trip to Boston out of it. With the bill they were trying to give me I could have. Mine was about $600. It was eventually cleared.
[…] our pediatrician is on our health plan but the lab she used was not, which led me to write an angry letter to Humana last […]