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We won!
After the recent awful discovery that we were not in-network with Humana as we had been told, we decided that we were not going to accept "too bad" as an explanation for our practice or any of our patients. To make a long story short, Humana has agreed to back date all claims filed from January 1, 2009.
What this means to you is that our billing company will resubmit all claims that have been denied. Many of you have been surprised to get copies of the explanation of benefits from Humana - especially if it says that you are responsible for the entire bill. The cost of health care is indeed shocking.
The amount billed is rarely the amount that is paid by the insurance company. Insurance companies have predetermined amounts they pay for each service or procedure. Each insurance company also determines how much responsibility the patient has for that amount. In some cases the patient has no further responsibility after the copay has been made.
More commonly, the patient is responsible for a percentage of the cost after a certain deductible has been met. Usually this percentage is around 20% but it can be more or less.
Check your insurance card or look online at your insurance company's website if it has one to learn more about your coverage.
This was good, good news for us and we could not wait to share it with our Humana patients!
Only 36 more days until spring...
