For once, I am at a loss!!! So it seems that the drama of Humana continues. In January, we started under a HMO plan...it imploded. Humana switched us to POS plan in March. Great, problem solved, except claims for jan and feb werent being paid. Jump to three weeks ago. Got letter from humana that states the marketplace made mistake In that HMO plan should never be made available to us. Only one available...the POS plan we are now on. No biggie. I called the market place to explain. Find out humana screwed up. They cant switch plan without telling marketplace. So they will deal with them and went ahead and switched us, made retroactive back to jan. Great, claims not paid will now be paid. First sign, pain management confirmed Kenzies appt, next day she shows up, its cancelled. Reason, they dont take our insurance??? Weird. So, now at ER, they admit her into Kennestone. Wife gets call from advocate that they dont take the HMO plan and Kenzie has to be transfered. WTH? Nicole explains thats incorrect, we are on POS plan. Problem solved, all is good. Today, they stopped IV meds and informed Kenzie she had to be discharged because they dont take HMO. WTH? I call Humana. Seems instead of canceling g the HMO, they cancelled my POS, re enrolled us in HMO, billed me $6300 for premiums for months I havent paid, seem they have no record of premiums I paid for POS plan. Cant explain why claims state POS? They offer to transfer her to north side or Atlanta medical center since they take HMO and come to find out, they refuse to take her. I fight near the top of the chain And they call marketplace that confirms all I said is true. I have her call because we are now eligible for a waiver to keep her in Kennestone. Nurse calls me, speaks with her medical director, who refuses to give waiver, and they left Kenzie in the room on oral pain med. all drs refuse to come in room and treat her and will give no orders. So Kenzie is out, others refuse to take her, we have no hospital and as of now we have no drs because none take the HMO. I am just stunned and have no idea what to do?
Posted on: Thu, 07 Aug 2014 00:52:36 +0000
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