Guest guest Posted June 24, 2003 Report Share Posted June 24, 2003 yes, I have Humana and they paid $11900.00. Just keep trying. Get your agent involved. It took 8 months for me to get my money. Joyce Laws Humana Insurance > Has anyone been paid by Humana or Choice Care? > > I was pre-approved, but now Humana does not want to pay for the surgery. It is due to the fact that I received an itemized invoice from regional for the full fees when the actual charges were discounted. They say they would pay if they could see the actual fees between Dr. Rutledge and Regional. > > Has anyone delt with this issue and been successful with Humana? > Thanks for any help! > Don W > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 25, 2003 Report Share Posted June 25, 2003 I have Choice Care - Humana. I live in Cincinnati, Ohio. When I first sent my global billing in they sent me a check for approximately $3,500.00 approving about 80 percent and a $300 deductable for out of member service. I obtained my records from Dr. Rutledges office for the post operative report and records from Regional. There was some sort of itemized list of costs for the hospital. I wrote an appeal letter earlier this month and am waiting for a reply. Don and Joyce, what state is your coverage in? I will let you know what the result of my appeal. Irene Diesel > > Message: 10 > Date: Tue, 24 Jun 2003 18:40:16 -0500 > From: " Joyce Laws " <jlaws@...> > Subject: Re: Humana Insurance > > yes, I have Humana and they paid $11900.00. Just keep trying. Get your > agent involved. It took 8 months for me to get my money. > > Joyce Laws > > Humana Insurance > > > > Has anyone been paid by Humana or Choice Care? > > > > I was pre-approved, but now Humana does not want to pay for the surgery. > It is due to the fact that I received an itemized invoice from > regional for the full fees when the actual charges were discounted. They > say they would pay if they could see the actual fees between Dr. Rutledge > and Regional. > > > > Has anyone delt with this issue and been successful with Humana? > > Thanks for any help! > > Don W > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 26, 2003 Report Share Posted June 26, 2003 I am in Tennessee. Joyce....good luck Humana Insurance > > > > > > > Has anyone been paid by Humana or Choice Care? > > > > > > I was pre-approved, but now Humana does not want to pay for the surgery. > > It is due to the fact that I received an itemized invoice from > > regional for the full fees when the actual charges were discounted. They > > say they would pay if they could see the actual fees between Dr. Rutledge > > and Regional. > > > > > > Has anyone delt with this issue and been successful with Humana? > > > Thanks for any help! > > > Don W > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 24, 2003 Report Share Posted December 24, 2003 Hi , I looked at our insurance database and it seems like Humana is all over the board, they ranged from paying 0% to 60% to 80%. My advice is to appeal, appeal, appeal! If you look at the toolbar on the left side of the message board there is a section labeled FILES, there is a folder in there for insurance help. Good luck and I'm glad to hear that Raegan has adjusted to her band. Natasha > I am fairly new to the group, I have a 5 month old daughter, Raegan, > who was diagnosed with positional plagiocephaly 3 weeks ago. Since > then we have already requested pre-authorization for a DOC band from > Humana, and been denied. I was fully expecting this, and have > already started my extensive research for my appeal. I was wondering > if anyone knows if Humana has covered cranial banding for a non- > synostotic plagiocephaly? Any advice would be great! The good news > is we did not wait, and Raegan is doing well with her DOC band it's > the 2nd day. Happy Holidays to all of you! - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 24, 2003 Report Share Posted December 24, 2003 , that is great news that Raegan is doing so well in her DOCBand! Your past the hardest part. Just sit back and watch her round! Now to the insurance.......ugh! If you look in our " files " section there is a insurance file in there. Great info to look through. Keep appealing until you WIN!! Has you referring dr. written a letter of medical neccessity? Sometimes that is all that is needed to get an approval. Good Luck and keep us updated on how the insurance problems are coming along and how Raegan is correcting. Merry Christmas!! Dustie > I am fairly new to the group, I have a 5 month old daughter, Raegan, > who was diagnosed with positional plagiocephaly 3 weeks ago. Since > then we have already requested pre-authorization for a DOC band from > Humana, and been denied. I was fully expecting this, and have > already started my extensive research for my appeal. I was wondering > if anyone knows if Humana has covered cranial banding for a non- > synostotic plagiocephaly? Any advice would be great! The good news > is we did not wait, and Raegan is doing well with her DOC band it's > the 2nd day. Happy Holidays to all of you! - Quote Link to comment Share on other sites More sharing options...
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