Insurance woes

[Guest guest]

This is the stupidest thing I have ever heard.

In the last 2 weeks, I have recieved multiple statements from several

different medical centers we use, stating that they have had no

response from my primary ins.

so I called my ins, and they tell me over the phone that they havent

paid these claims b/c they have never recieved them. So I call the

medicla facilities back, and they are able to give me dates and

addresses and phone numbers, w/o me telling them, of when and how they

sent the claims for services, and now many times Humana did not respond.

also, when medicaid denied the portable neb, I called Humana just to

see if they ever approved it(b/c, first the primary has to approve or

not, then it goes to medicaid to approve or not, and mediciad didnt

approve it, but I never did hear back from Humana on it). so, about a

month ago, I called Humana and they tell me no, they have never even

received a request about it, ever, never once has it been in their

system any request for anyone in my family to recieve a portable

neb(it was for savannah).So I called the drs office back, and asked

them to re-send a request along with the letter of medical necessity

for savannah to get a portable neb.

Never heard back.

Yesterday I called the benefits person at DH's work, and gave the

times I called the ins. the names of the people I called, and told her

what all was going on.

Today she called me back and miraculously, they have paid everyone!!Of

course they paid them, the claims were all in the system, everything

is paid--this is what they tell her. AND, they claim they have sent

TWO approval letters to the drs office regarding the portable

neb(which really should have gone to the med equip store).

Now, how did they do that, when the request was never in the system to

begin with?

Also, they told me when I called, there was never a request in the

system for the lung percussion device, WHICH THEY PAID FOR ALREADY.

AAAHH!!

So, basically, Humana made me look like a liar, when I have these

bills in front of me stating --no response from humana. But I cant

prove this to the benefits person, who says when she called,

everything was all set.

I HATE this ins. I MISS Bc/Bs in the worst way. But, we had no choice

about changing.

If only you could choke a person over the phone............

but, on a good note, I got in the mail today a letter from the inf dis

dr stating that no, Brennan is not ALLOWED by him to go to school

based speech therapy, he MUST remain in private therapy due to his

CVID, so they will have to fork out for it. I am really happy about that.

Valarie