ComplaintsforHumana, Inc.

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Initial Complaint
09/25/2024
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I have $2,500.00 coverage on my dental plan with Humana. I needed a ***** *** ***** ****** ***** They assured me that I was covered by my plan for the first $2,500.00. They only paid $1,250.00 on a bill that was $2,586.50. I have paid the dentist $100.00 to cover the overcost. Humana has continued to ask for information such as ***** and other forms, which the dentist has sent to them several times. They are delaying with the hope that I will give up and pay the difference. A woman, ****** from ***** ***** called and asked how Humana was treating me since her company initially contacted me about signing up with Humana. She contacted Humana and was initially told they would cover the bill. We called them a week later, and they said they would pay nothing further. They also, for no apparent reason, voided the first six charges totaling $470.50. These charges were for fillings and *****. There is no reason for Humana not to cover the bill. When I first called, they gave me reference number ************* and said the bill would be paid. When I called them a week later, they could not find the original reference number and gave me a new one: ************* When ***** **** ****** ************ *** ***** called with me, they could not find the first reference number, found the second and then magically found the first one. ***** is also at a loss as to why they will not cover the remaining amount. Humana needs to pay what they promised.
Business response
10/02/2024
A response has been mailed to the member.
Customer response
10/09/2024

Complaint: ********

I am rejecting this response because: it will take from 30 to 60 days to get this resolved through them. This will close the window I have with the BBB. I want to keep this claim open until they give me their response. I am also not happy with the fact the person who I have a complaint against saying they will investigate and come up with a solution. We have talked with them several times concerning this issue and have been told the same thing. I don't expect they will change their minds.

Sincerely,

******* *****
Business response
10/10/2024
A response has been mailed to the member.
Initial Complaint
09/23/2024
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Dear Humana Dental Claims Team, I hope this message finds you well. I am writing to formally request an expedited review of my dental claim related to my treatment with *** ******* ********** ***. I have been waiting an extended period for resolution, and this delay is significantly impacting my ongoing care at **** ******. The dental office has submitted all necessary documentation to Humana, yet the claim remains unresolved. The prolonged waiting period is causing concerns regarding my treatment plan, and I urgently need clarity on this matter to proceed with my care. I kindly ask that you prioritize the review of my claim to ensure my dental needs are addressed promptly. If there are any additional details or documentation required from my end, please let me know, and I will provide them immediately. Thank you for your attention to this urgent matter. I look forward to your prompt response. Sincerely, ******* ********* - Member Number ************
Business response
10/04/2024
Response has been sent to the member.
Customer response
10/05/2024

Complaint: ********

I am rejecting this response because: Humana has not answered my issue. The claim is still processing and which someone from Humana Dental to contact me to discuss the matter. This issue is getting beyond lengthy in time, and is not right to treat senior citizens this way. I have no reason to file an appeal as again the claim is still "pending".

Sincerely,

******* *********
Business response
10/10/2024
Hello. The final response for the above mentioned case is complete and attached for your review. You can give me a call should you have any questions.

Thank you
Initial Complaint
09/23/2024
Complaint Type:
Billing Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
I visited ****** ****** on July 26, 2024, and received a deep cleaning. I was informed by ****** ****** staff that my Humana Dental Insurance would pay for the deep cleaning. ****** ****** staff stated that they had contacted Humana and was given information that the deep cleaning was cover under my insurance. It appears that Humana customer service staff gave ****** ****** false information regarding the deep cleaning being covered under my Humana Dental Plan. I should not have pay $800.99 for miscommunication on the part of either Humana or ****** ******.
Business response
10/14/2024
See attached response from the business.
Customer response
10/14/2024

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********* and find that this resolution is satisfactory to me.

Sincerely,

**** ****

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Initial Complaint
09/10/2024
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
see Attached document
Business response
10/14/2024
See attached response from the business.
Business response
10/15/2024

Humana®

** *** ***** ***** *** ** ********** ******* *** ****

**** ********

Better Business Bureau, Inc. ***** ********* **** **** ********** ** ***** *

Case No.: Entity Name:

Requester Name: Inquired About: Humana Case No.:

******** ****** ********* ******* ****** ****** ****** ****** *** **** ****** ************* * *

Dear *** *********

I am writing in response to the inquiry you submitted to Humana on behalf of ****** ******.

In reviewing the complaint information, we have noted that there is no signed Appointment of Representation (AOR} form enclosed that would authorize us to communicate directly with you or *** ****** regarding **** ******. In order to comply with the Privacy Standards as defined in the Health Insurance Portability and Accountability Act (HIPAA}, we are sending the response regarding **** ******** claim directly to her.

Enclosed is a copy of the resolution letter sent to *** *******

Please feel free to call me if you have any questions or concerns regarding this matter. You can reach me at ************* **** ******** Additionally, you may email me at *********************************

Sincerely,

* *** ** ************** ****** ******** ******* **********

(Enclosure)
Initial Complaint
09/03/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
see Attached document
Business response
10/01/2024
A response has been mailed to the member.
Initial Complaint
09/03/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Humana Dental is stating that *** ****** *** was not "in network" when i received services in their office. However, the office staff contacted Humana dental prior to my appointment and they were told *** ****** *** was indeed "in network". Humana Dental paid the claims for my services but now they are asking for the payments back from *** ****** *** and I will ended getting billed for these services. This is clearly an error on Humana dental's part and I am requesting resolution of this matter. This is unacceptable. Thank you.
Business response
10/14/2024
A response to the member was mailed on 10/4/24
Initial Complaint
09/03/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Humana dental is stating that *** ****** *** was not "in network" when I received services in their office. However, the office staff contacted Humana Dental prior to my appointment and they were told *** ****** *** was indeed "in network". Humana dental paid the claims for my services but now they are asking for the payments back from *** ****** *** and I will ended getting billed for these services. This is clearly an error on Humana Dental's part and I am requesting resolution of this matter. This is unacceptable. Thank you.
Business response
09/19/2024
A response has been mailed to the member.
Initial Complaint
09/03/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I received services in their office. However, the office staff contacted Humana dental prior to my appointment and they were told *** ****** *** was indeed "in network." Humana Dental paid the claims for my services but now they are asking for the payments back from *** ****** *** and I will ended getting billed for these services. This is clearly an error on Humana dental's part and I am requesting resolution of this matter. This is unacceptable. Thank you.
Business response
09/18/2024
A copy of the response was mailed to the complaint
Initial Complaint
08/21/2024
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I was told by Humana and received a letter that my giveback was all straightened out and I would not have any more problems. I have been on hold in the last eight months for many hour's talking to eHealth, Humana, Social Security and ********. Things are still not straightened out, I keep getting the run around every place I contact!
Business response
08/29/2024
A response has been mailed to the member.
Customer response
09/03/2024

Complaint: ********

I am rejecting this response because:
This is the same letter I received before I filed this complaint several times. I am owed over $550 giveback from Humana. I was told by Humana Agent that I would be getting $164.90 giveback every month instead of $100.00 giveback. I have spent hours on the phone with Humana, ******** and Social Security. All I have learned is Social Security and ******** that they have this same problem with Humana all the time?? I will also file a complaint with Comsumer Right and I will not drop this complaint. Also in December I will go with a different Healthcare Provider. Thank you
Sincerely,

****** ******
Business response
09/06/2024
The final response for the above mentioned case is complete and attached for your review. You can give me a call should you have any questions.

Thank you,

Customer response
09/10/2024

Complaint: ********

I am rejecting this response because:
Same old response, just a different day!!
Sincerely,

****** ******
Initial Complaint
08/20/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
This involves my situation of my wife and I both getting a PPO policy and my wife ***** winding up with a very low coverage dental plan compared to mine. I filed a grievance to upgrade her dental plan... that barely covers a checkup and two cleanings per year only, NO fillings or crowns nothing else!! Mine covers 4 cleanings per year with a $2,000 per year coverage for crowns, fillings etc. I filed grievance # ************ and the people at Human just keep dragging this on with NO solution! They gave me an Appointment of Representative form to fill out.. I filled it out and faxed it back 3 times.. they keep sending another virtually every week!! They keep claiming that they never received it!! Simply to have my wife's spouse (me) communicate with them over this injustice!! They are either very stupid or they are just playing ongoing games with this situation. All we are asking for is a fair dental plan like mine... since we are husband and wife and both have PPO plans. And they are resisting this.. seemingly until the end of time of our policies. I think everyone in the USA should know about Humana's tactics to the consumer!! Some blogging is in order next. I surely hope *** ***** ** ********* CEO of Humana, gets the info right away!! Sincerely, ***** & *****
Business response
10/09/2024
Hello. The final response for the above mentioned case is complete and attached for your review. You can give me a call should you have any questions.

Thank you,

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