My husband and I had a baby in June 2009. We decided to cover the baby under his health insurance (Humana). He has only been at his employer for a year and a half and never used his health insurance. After getting information we decided it seemed simple and it would make more sense for the baby to be covered under his insurance instead of mine since I was going down to part time and would lose my insurance. We contacted Humana and were told to find a physician on their physician finder website. We did this, found a pediatrician we liked, and started going to their office. When our child was 2 months old and had been to the office 4 times and had received 3 shots and an oral vaccine, we started receiving EOBs stating that Humana was not paying for ANYTHING. They were saying that our pediatrician was not in-network and we would have to meet a $15,000 deductible before they would cover anything at the office. After countless e-mails to my husband's company's insurance representative we were reassured that it would be covered and the Dr's office was simply using the wrong tax ID to submit their claims. We continued to receive bills from the Dr's office but were told by Humana not to worry they would be covered. We also continued to take our son to the same Dr.
Well our son is now almost 5 months old and we just found out last week that we ARE responsible for the Dr's office bills because they are out of network. After all this the physician is still listed on their physician finder website and the office manager at the Dr's office even said they were a participating provider for Humana! I don't think anyone knows what they're talking about! One Humana representative told us that the Dr was only covered if you saw him at an urgent care facility across town! No where on their website did it state this!
Overall we have had the worst customer service ever from Humana. We now have to go to a Dr that we do not like, whose office is over-populated, and takes almost 2 hours for a well-baby visit! We are now responsible for almost $1000 to a Dr's office that is now harassing us. Is there anything we can do!?
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