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B
7:25 am EDT
Verified customer This complaint was posted by a verified customer. Learn more

Humana - network participation status?

Our practice has been told our providers are out of network with Humana Medicare PPO. I called Humana on 8/22/17 and stoke to Vel M. who provided me a call reference # 20000026551168 and verified both of our doctors are IN network with Humana Medicare PPO. He said he would also send a request to contracting to call me. I have yet to be in touch with anyone from contracting.

Our providers are:
Dr. S. Mark Tanen, NPI: 1174562540, TIN: 088723671
Dr. Frank R. Crantz, NPI: 1861439374, TIN: 380488274
Location: 7921 Jones Branch Drive, Suite 320 McLean, VA 22102

We would like an affirmative answer on the Humana products we are in network with.

PLEASE CALL ME AT (703) 544-7021 OR EMAIL ME:
[email protected]

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3:32 pm EDT

Humana - customer phone number

I have made several calls to ask questions about my insurance. I have been placed on hold, disconnected or mainly the foreigners you have answering the phone, does not understand the question. I am not sure whether the answer they give me is correct. when you ask to be switched to an American representative you may get disconnected 3 or 4 times. I hate contacting Humana. Your customer service stinks.

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1 comment
P
May 26, 2018 11:01 am EDT

I have been trying to get information from Humana Customer service for over a month. The service center is in Colombia, the reps are nice and well mannered but they simply will not or cannot provide any information. I believe it is a planned policy by Humana to not provide any information so a person will not attempt to get care. I believe this is also probably illegal. This site is filled with similar comments and complaints.

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12:48 pm EDT
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Humana - humana gold advantage

I have my retrieved recorded conversation for my original application submitted to Humana. I changed from Medicare A & B starting on
August 1, 2017 to Humana, that promised to cover my choices. My choices included Providence St John's Hospital 2121 Santa Monica Blvd. SM 90404 along with my Primary Care Doctor, Dr. Adam Karnes, 5901 Olympic Blvd, Los Angeles 90036.

On August 21 I was scheduled for surgery for Magalent Melonoma stage 3 on my Face. My surgery was denied while I was in the waiting room of the hospital getting ready to have surgery. I called Humana immediately, and you have assigned me to the wrong Network, including a primary care doctor I have never heard of, who works in a hospital that I did not choose.

After a nightmare of customer calls, complaints, during that week and an almost breakdown, my oncologist scheduled another surgery for Monday, August 28, 2017. I waited for a last minute approval for the hospital bill at Providence St. John's. I got a denial even though it was Humana's original mistake in putting me in the WRONG NETWORK.

I arrived at the hospital and they handed me a bill for $11, 500 before I went into surgery. I demand to be REIMBURSED FOR THIS BILL.

I have evidence that Humana's practices did not cover me due to negligence and malicious practices to avoid paying my hospital bill. I have copies and records of CHAT CONVERSATIONS with Humana customer service employee, with direct reference to Networks, Primary care doctors, coverage of my Hospital of choice withing the network.

Sasha Neiman H 72526131
430 S. Fuller Avenue 2K
Los Angeles, California 90036
DOB 11/24/1943
#505 699 6125 cell phone

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6:13 pm EDT
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Humana - humana/surgical authorization process

48 hours from cervical fusion surgery i'm notified not by humana but by my surgeons' office that authorization for my surgery has been denied! Upon my calling humana and transferring me three times they connect me to a company called orthodex (Sounds like that anyway) there some lady tells me the nurse determined the codesed by the surgeon and the medical diagnosis/records do not meet criteria! A nurse undermined a neurosurgeon! From there they bounce me back to humana representative that says I have to resubmit authorization request and a humana nurse will determine if humana pays or not! I was told matter of fact that wedesnday sirgery isn't happening. When asked how long the new process would take humana wouldn't say.
I've been in pain for over 1.5 years and am tired of aspirin, opioids and more pain! They treated me as if I wanted a cosmetic surgery or decided that my surgery was for fun. Now I must endure once again all the ct scans, xrays, blood work and other tests again! Costing humana more money in the long run!

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2:58 pm EDT
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Used her job with Humana to travel for 7 years to conduct her extamarital affair. Used her boss (in dental) tim feree to organize the state of MS as part of her primary recruitment areas. Her husband is employed with Humana as well. Using company resources in an attempt to destroy another family is probably not part of Humana's mission, goals, or desired reputation.

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9:09 am EDT
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I went on a man with several times in the last 3 months to find a rheumatologist in my area I had one that prescribe medicine for me and made me deadly l when I called him he refused to address it so I no longer can you sing. Now I'm back to square one on humans website well there are no rheumatologist in the area and since I can't drive I have to hire...

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12:00 pm EDT

Humana - your whole system

First off you decline a test for someone to see if they have cancer or other problems. Dr did a test anyway and found out my grandmother had cancer. And yall just keep denying everything. Starts chemo and she got sick and in hospital ends up being aloud to go home after over a month and 2 or 3 days later your stupid case worker is not aware she was aloud to go home and still a week later no home health is set up. and the one you offer is not everyday and my mom is exhausted with no sleep for over a week cause yall are to lazy to keep up with your work. So my mom is crying because she is tired and can't function and you can not even do your freaking job. My mom has been taking care of my grandma for almost 2 months. She has not been home and has not gotten a chance to see her kids or husband or get her self ready for a new school year because she is a teacher. So our family has gone way beyond yalls stupid petty no caring offers and found home health places that are gonna try and take over what yall can't. I will laugh the day yall get sued over all the hell yall like to cause in peoples life. Unless yall just hope people do not live so you don't have to deal with that case anymore, yes i went there cause thats how we were treated and how yall acted to make us assume that.

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10:09 am EDT
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I m filing this complaint because I had a crown done on 08/25/16 by my dentist office. This is the first time I had a crown put in my mouth ever and I really needed it. The claims department is denying paying the bill which is covered under my insurance plan. I have called several times about this issue and is told that the bill will be taken care of. The...

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11:19 am EDT

Humana - finding rheumatologist in my area

Well I've been looking for rheumatologist for two months the ones posted in my plan are not a acceptable at all their complaints and reviews are on the down side. The one that I chose to go a while back well let's just say the medication that was prescribed maybe deadly ill even though I had complained about what I was feeling they did not take a interest they just kept prescribing it to me so I stopped it called up the specialty pharmacist and he indicated that I was allergic to it and that's how I was having all the symptoms when I tried to explain it to the doctor he completely ignored the issue I guess you didn't want to hear it it's easy to sweep it under the rug. So I called up humana and complaints The Next Step was to try and find a new rheumatoid doctor well that didn't go well they didn't have much in my area most them were 19, 20 miles and more no one wants to drive that far when that bill they will all in downtown Tampa and tampa not near to my home or my surrounding area they had nothing new at all I looked on their website up and down when I called them they had no answers so I guessed my next step would be to pull out a new man

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6:18 am EDT
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I signed up with Humana HMO coverage June 2015. I switched to the PPO coverage effective Jan 2016. At that time, someone at Humana entered another insurance company to my account, an insurance company I never heard of. In Feb and June of 2016 I visited my pulmonary doctors office. Since then Humana has refused to pay the billings. I contacted Humana and...

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8:15 am EDT
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Humana - service and phone conversations

I am so frustrated and stressed out with Humana Pharmacy. My member ID is H57767936, Kay Reich BD 7/12/2949. Speaking and being able to speak to someone on the phone is a disaster! I started having an issue this past week which really came to a head yesterday, 6-17-2017. I couldn't understand why i hadnt gotten one of my meds and online it was marked cancelled? It was sent in by my doctor on 6-7-2017. I finally received the other meds with much frustrating discussion but did not receive my Cloazepam. I called and that was a major Disaster! When i finally found the med online i had to order it myself? I dont even know if this was the right thing to do. I am so dissapointed in this pharmacy...the phone discussions and follow throughs have been so Poor...i am a very dissatisfied customer.

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6:29 am EDT
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Date 6-12-2017 I wanted to update and send you this letter so you have a more understanding of the events that has gone on in the location of Semoran CAC Clinic. This letter was necessary not because I am mad I did give a two weeks notice but more because of the discrimination and of others that If they don’t agree by choices or the things the...

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D
5:19 pm EDT

Humana - part d drug coverage for seniors

Endangering client’s health care - humana (Medicare) rx drug plan - profits from pain 4/26/2017 1:25 pm

I have had humana as my drug rx plan in ny for several years and now in florida since moving here a year ago.in ny it was determined by 3 specialists, that I am allergic to preservatives in eyedrops (It caused me severe blepharitis) and then the anti-inflammatory drugs to resolve this caused permanent vision damage to both my eyes. I have to use unpreserved eye drops to avoid vision loss. All the eye doctors I saw notified human of my sensitivity to preservatives and the need for unpreserved medications (I too am an eye doctor). Humana then authorized the (Not on the formulary) drops at a $45.00 copay each purchased month’s supply (After a yearly first purchase of $125.00).

I called today to get a price on the drops in florida, as recommended by my physician who thought she might be able to save me money by not using my drug plan. I was told by your rep 1-800-281-6918 that all the past reports my doctors filed were of no value. I was told that I had to start the process over and get new doctors to request this exception because it was a new year (Each year). You did not promise to make an exception in any case. I was also told the drug is not on your formulary and I would have to pay full price. The walmart discount prices is $175.84 for a month’s supply. It sells for over $200 / mo supply. It is illogical (And unethical) to ask me to go through the doctor request process each year. When your representative said I would have to do this I asked to speak to a supervisor since allergies don’t go a way. He then played the same trick all "annoyed" providers do and said he would transfer my call to customer services who would help. He promptly disconnected us. (He had my phone number and if he wished to call back he could have).

I am a retired doctor, I understand how you play games by forcing doctors to do unnecessary time consuming paperwork and phone work so that you can stop patients who need exceptions from getting the meds they need and for which they have paid your insurance fees for years. Sure you tell the patients it is their doctor’s responsibility to contact your service department as if it would take just a moment or two. When I was a practicing doctor, I would have been doing this all day! Doctors are paid poorly enough already and now you add to the injury by making them do unnecessary paperwork or spend time on the phone with your company (Which hangs up on them too) which is not possible for them to do today. It is a neat little way of deceiving your patients. You tell them ask your doctors to get an exception and put the blame on the doctor.

Having a formulary that allows you to negotiate for a lower price with a drug company is not a bad idea. However when a patient needs a drug not available on your formulary and when there is no alternative on our formulary, making them jump through hoops to deny services is unethical. We as patients, all know the stories of suffering senior citizens who live in pain because they cannot afford the medicines they pay their plans for. The medicines they can get from canada pharmacy cheaper than with their drug plans.

As patients, you take our money in premiums with false promises of care and then deny service for greater profits. Nothing could be more unethical other than directly causing injury to your clients by stabbing them with a knife or shooting them. You get away with it indirectly, without putting a knife in them, by denying services. I wonder how this would read on the internet? I gave you 24 hours to set this straight in writing and then I waited w weeks. On 4/26/2017 I then sent my email to your customer services and received no response. Today is 5/9/2017 if you intended to respond, 2 weeks was clearly enough time. This clearly paints a picture of the ethics behind your services and your concern for your clients. Dr joseph a ross

5/30/2017 — the human drug plan rip-off only gets worse.

My eye doctor prescribed a second med for me today. Unpreserved again because I am allergic as documented. This drug was also denied. Now she is going to write to them to see if they can get it approved. Meanwhile the records for several years show (At their company) that I am allergic and that does not change.

Today my wife needs and eyedrop for post surgical care. The drop is called prednisone. When she went to pick it up today they charged her an $80.00 co-pay. I went online to canadian pharmacy to see what it would cost without insurance. The price in us dollars is $27.00 and it is the same product from the same company, allergan. Get this straight now: with insurance $80.00 without insurance $27.00 ……….. How ethical is this? I looked at humana’s ratings online.

Rating: 1.2 stars out of - ‎367 votes

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8:39 am EDT

Humana - denial of prescriptions, poor phone connections

In 2014 I had cervical spinal fusion, thank God I had Excellus then. Now my employer switched to a Humana PPO. After the surgery I was left with severe nerve pain in my arms and hand, also I have lost dexterity in my hands. My doctor prescribed lidocaine patches for pain. Humana denied it, the doctor wrote a certificate of medical necessity, they denied it. I filed an appeal they denied it.The only medication they will allow me for the pain is lidocaine ointment in a 30 gram tube for a 30 day supply, when you get sample toothpaste from the dentist that is 27 grams. The amount of lidocaine they allow lasts about 5 days. With out the lidocaine I have had to increase the amount of Ativan that I take, the amount of Neurontin that I'm on and add 2 arthritis strength tylenol. I've had two doctors tell me this worries them because I'm heavily sedated, but it is the only way I can sleep without the patches. I also have asthma and I wasn't able to use an inhaler when I have an attack. I told my allergist and he said that there was one brand that people with poor dexterity could use, Humana denied it. I called them on the phone, an awful experience. You often get a poor connection, I've even had to hange up and call back, also you have to give information such as name, address, d.o.bo. and your Humana id number to everyone you talk to. They denied me the inhailer and would only a generic brand that I have trouble opening. As a result of nerve damage, I have difficulty walking, and I have major balance issues. I have to use a cane. One of my doctots prescribed orthodics to help with my balance, Humana denied them. I called Humana they denied it again. I am currently seeing a podiotrist, when I asked him about Humana his exact words "They suck." I am also seeing a pain management doctor, when I asked her about Humana she said "I only have trouble with two insurance companies, Humana, they are the worst and Fidelis.

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11:32 am EDT

Humana - revoked prior authorization at last minute/refusal to ok procedure even after trial was met.

April 21, 2017 my husbands primary insurance and Humana BOTH agreed that no prior authorization was necessary to implant a pain pump for his stage IV metastatic cancer pain.
April 24, as my husband was being wheeled in for surgery Humana called the Dr and said he did indeed have to do the trial. We debated and then the Dr did the spinal block to test the medications efficacy.
It is now April 28 and Humana has decided to deny the pain pump even though the Doctor himself has called and asked for an expedited appeal.
In essence, they are torturing my husband by denying appropriate pain control.
This is not the first time we have gone rounds about prior authorizations since my husband's diagnoses March 6 2017. It took two months for chemo to be approved. This is absolutely inhumane and needs to be addressed.
I called Humana today after the Dr office called me and was told it was because the diagnosis of neoplasm pain was insufficient. Why couldn't they have told that to the Dr office the last 4 days in the more than dozen times they have called?!
I ended up speaking with almost half a dozen people whom all spoke with multiple departments and still got nowhere. In fact, they disconnected me and told me my phone call was unable to be completed.

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11:15 am EDT
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Humana - clinical pharmacy review-impossible to get information

As of today 4/19/2017 I have spent more than four hours speaking with a variety of people in different departments to try and understand why a Tier Reduction Request was denied and what to do about it, since the letter was rather vague. It should be a simple question to answer: exactly what further information is needed and on what form. I have gotten several incorrect pieces of information, been switched to other departments who also didn't seem to know what to do, misinformed by a supervisor about what form to use and hung up on by another person when I voiced my frustration.
I have been really shocked by the level of either incompetence or misinformation of your representatives about a request that was already approved in the past by Humana.
Carolynn Maltas
H45330576
617-497-2124

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3:09 pm EDT
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Humana - humana clinical pharmacy review

My doctor finds a blood pressure med that works for me and was keeping my bp in good numbers. So when I go fill my olmesartan medoxomil I was turned away. It seems that humana knows my health needs better than my personal doctor. Blood pressure is not a game that you should play with when a doctor knows what is working for me. My doctor filled out your proper paper work and humana wants me to try other medications instead of what can keep me alive! It is obvious that you are big business and do not care about the patient or his family; you just care about making the most profit you can at any risk! Now there is a appeal procedure that I must take to prove that my doctor is right and that the humana jury is wrong! (Really)!
All in the meantime I go without bp meds, but hey thats ok with humana because they dont care about how your health is, they just care about the bottom dollar.

Sorry but this is how I see your company now.
Thanks for putting my health at risk...

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2:16 pm EDT
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Humana - prior authorization

Good Day my name is Shamel Byrd I am an RMA with Novant Heart and Vascular, and I have a complaint/request. When we receive these Prior Authorization for the patients the fax we receive from your office only has patients first and last name and Human Member ID, which is not very helpful on our part when we are trying to locate who the patient is. This leaves us typing in the patient first and last name and have to go threw each patient in hopes to luck up on the patient who the letter may correspond with. If we call your 800 number the customer service rep will not help us with finding out who this patient is as well so now the patients medication is now on hold because we have to find out who this patient is, we can not look up a patient in our system threw there Humana ID number . If you send a letter for a John Doe could you image how may john doe I have to go threw to find out which one this letter is for. I would really like to know if a date of birth could be added to these letters even if you guys add the patients address we can even look it up that way but they way you guys are sending out these letters are not helpful for us or the patients. I really would appreciate your help in this matter thank you so much in advance.

Sincerely,

Shamel Byrd
704-347-2030

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5:58 am EDT
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Humana - liability to insure people's health

Humana has wrongfully miss represented my insurance as a "network" instead of the only one I would have ever agreed to since I just went through a lengthy above the knee amputation just months before, ppo plan.

Per your later dated may 16, 2026, "i enrolled in the ppo plan which was august 1, 2015 not january 1, 2016.

This has been my worse nightmar! It has stopped my progress to over come the prothesis because of all these unpaid medical bills & added stress!S & as of last friday are went into collection status which is running my credit!
I have been so overwhelmed & stressed with the extra stress of people calling for there money that I had to go to er 3-4 times with panick attacks! It took me months to figure all this out & have been too upset to call & could not talk. I spent days trying to get help on all this. I finally mailed them a leter & assumed it was handled since ms jennifer guynes, insurance broker for humana, give me her word that it was fixed.
§
See attached - copy of letter dated may 11 2916
See attached - copy of my calender log for july 29, 2015 telling humana ppo only

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1:48 pm EST

Humana - medicare supplement insurance plan f

I wish to make a complaint about Humana and my Medicare Supplement Insurance Plan F. Humana cancelled my Plan F as of October 31, 2016 due to non-payment when in fact they did receive the payment before October 31, 2016. I was told I could reinstate the Plan F if I sent in another payment. I immediately sent in a second payment and was told the Plan F was reinstated. I found out later that the Plan F was never reinstated and was stilled considered cancelled as of October 31, 2016. There was never any communication from Humana about anything regarding the cancellation or what happened to the two payments I sent them. Upon called Humana again I found out after a lot of aggravation and dealing with some very rude customer care representatives that my two payments were credited to me and were just hanging out for two m months and were not applied to my Flan F payments. I asked for them to send me a check for the two payments. They said they would refund my money. It has been over a week and still no check from them. I called again today and was told that the refund is still being processed. How long must you wait for a premium refund when they mess up and you have to pay your premium asap to them. I will wait a few more days and them will have to contact an attorney because it seems to me that they are trying to steel money from me at point. I wonder if their need for money is because the deal for them to be bought by Aetna fell through. I was told by a licensed medicare supplement agent recently never to deal with Humana again.

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