January we confirmed with their automated systems and their representatives that patients were current on their insurance. Then when the claims were submitted for payment they were denied by Humana saying that the patients were not eligibility. Services were performed with the expectation that Humana would pay their portion. One of the patients had cancelled their insurance with Humana and 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 to not punish 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
Product or Service
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