Humana Military - TRICARE Claims

[Anonymous]

Dealing with Humana for our TRICARE Select claims has been a hassle. They have denied several claims because primary insurance info. is missing. I have completed the other health insurance questionnaire and submitted it to Humana several times to show that we no longer have other health insurance, and that Tricare is our primary and only insurance. Anyone else having this issue? How can I escalate the complaint with the claims department?

[Anonymous]

That's why we use prime.

[Anonymous]

Anonymous wrote:That's why we use prime.

Do you go to an MTF?

[Anonymous]

It’s a nightmare and escalating it is a dead end.

Check out Humana Military Facebook page. They don’t care and no one gets help. Not kidding either.

[Anonymous]

The transition is not going well. They can't seem to get their records correct about other health insurance. Definitely check all your claims carefully. At least the website is easier to use.

[Anonymous]

Anonymous wrote:

Anonymous wrote:That's why we use prime.

Do you go to an MTF?

Yes, and only go when they refer us out and then its preauthorized and no problem.

[Anonymous]

Constant issues with this. I had to escalate up three people to finally get our primary insurance information correct.

[Anonymous]

Anonymous wrote:It’s a nightmare and escalating it is a dead end.

Check out Humana Military Facebook page. They don’t care and no one gets help. Not kidding either.

I checked the Facebook page but I didn't see any comments. However, I don't have a facebook account so perhaps the comments can only be viewed if you log-in. Can you please send me the link the specific thread? TIA

[Anonymous]

I could but it's so so much...you need to make a fake account so you can view their crappy page and go back starting with the transition this January. EVERYBODY IS HAVING THE WORST PROBLEMS.

I don't use facebook as I loathe it but I made one just to see Humana Military and Tricare's page. I know, weird, but I refuse to do facebook. Use a fake generic name and a picture of a flower or something for your photo if you want a fake profile.

If you want to use your real identity an account, and if you post on Humana Military with your issues, their page admin will elevate your concern but you have to have fb messenger to send details and sponsor SS.

They come out with alot of info about upcoming Tricare changes on the Trucare fb page so follow that if you feel you need to.

Also, Tricare people: check out MOAA for your Tricare updates! Without them we'd be screwed!

http://www.moaa.org/Content/Benefits-and-Discounts/Health/Health.aspx

Tricare is changing and you must enroll in a plan and stick to it in 2019, unless you have a QLE. Also if you are anything but Prime you MUST enroll in your plan this fall or you will be locked out for a year! BASTARDS!!

[Anonymous]

sorry for typos typing one hand

[Anonymous]

Keep at them. We had problems too. If we don’t give up they will have to do better.

[Anonymous]

I have Tricare Select and have never had it file my own claim. Are you all using out of network doctors?

[Anonymous]

Anonymous wrote:I have Tricare Select and have never had it file my own claim. Are you all using out of network doctors?

We have Tricare Select and don’t file our own claims and they are still being process incorrectly! Different poster

[Anonymous]

Anonymous wrote:

Anonymous wrote:I have Tricare Select and have never had it file my own claim. Are you all using out of network doctors?

We have Tricare Select and don’t file our own claims and they are still being processed incorrectly! Different poster

+1. The medical service was provided by an in-network provider. They filed the claim, TRICARE denied it because their system showed we had other health insurance. I called TRICARE and told them I've faxed/mailed the form showing we no longer had other health insurance several times in the last few months. The representative indicated that their system does show that we no longer have other health insurance and that they have received the necessary paperwork from me. This particular service was pre-approved by TRICARE because it required pre-certification. They will re-process the claim. However, they are back- logged and the claim will take 30-60 days to reprocess. In the meantime, I have a follow-up visit with the provider. When I show up for the visit, they will ask me to pay the $1,200 because the claim was denied. After TRICARE pays the claim, I will revise a refund but the last time this happened, it took 5 months to get a refund from the same billing serve.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have Tricare Select and have never had it file my own claim. Are you all using out of network doctors?

We have Tricare Select and don’t file our own claims and they are still being processed incorrectly! Different poster

+1. The medical service was provided by an in-network provider. They filed the claim, TRICARE denied it because their system showed we had other health insurance. I called TRICARE and told them I've faxed/mailed the form showing we no longer had other health insurance several times in the last few months. The representative indicated that their system does show that we no longer have other health insurance and that they have received the necessary paperwork from me. This particular service was pre-approved by TRICARE because it required pre-certification. They will re-process the claim. However, they are back- logged and the claim will take 30-60 days to reprocess. In the meantime, I have a follow-up visit with the provider. When I show up for the visit, they will ask me to pay the $1,200 because the claim was denied. After TRICARE pays the claim, I will revise a refund but the last time this happened, it took 5 months to get a refund from the same billing serve.

It's now a scam. spend hours on phone to get things fixed- no fix.

I have had MULTIPLE cs representatives not even know the basics of tricare. i have corrected them and am shocked these people are in charge of this program. and nobody cares.