In January we confirmed with their automated systems and their representatives that patients were current on their insurance. When the claims were submitted for payment, Humana denied them, saying the patients were not eligible. Services were performed with the expectation that Humana would pay their portion. One of the patients had cancelled their insurance with Humana in February, and yet the automated system said they were current and eligible.
Humana issued a check and then expected us to refund the amount due to their error. Since we did NOT refund their money, they took the money from another patient's check and sent us the difference.
Resolution Sought: Give accurate information and pay for their mistakes instead of punishing their participants.
Date Problem Started: 4/1
Date of Transaction: 1/5
Amount in Dispute: $212.00
Invoice Number: 2012
Complaint Type: Customer Service Issues
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