NBC6 Responds helps woman recover thousands for medical claim reimbursement

Diana Gonzalez is still healing after losing her dad in 2020. “What happened to my dad was tragic,” she said. “He got sick, he got worse, he got leukemia – that shouldn’t have happened.” She said her dad had traveled to Colombia during the pandemic and ended up needing medical care during that trip. She confirmed he had coverage through Humana, she said. “They said, well, you know, since it’s out-of-state coverage, we would pay for it, but you have to pay for it upfront, so I did,” Diana said. Diana paid nearly $14,000 and later filed a claim for reimbursement, which she said was approved. “I received three checks, but they were under his name,” she said. Her father had already died when the checks arrived, so she called Humana and was told they would reissue the checks under her name, she said, since she had the required legal documents. So, she returned the initial checks. When she got one of the new checks, Diana said she called to follow up about the rest. “It’s in the system,” she said she was told. “It’ll take some time because it has to go through another account.” That was back in 2021. Diana would spend the next three years calling Humana every few weeks and waiting, before she decided to ask NBC6 Responds for help. “It was something that was approved and they’re just giving me the runaround,” she said. “I always hear stories that you guys are always on top of things and resolve it. If it can’t be resolved then, you know, I don’t know what else to do.” NBC6 contacted Humana on Diana’s behalf. They told NBC6, in an email, “…federal privacy regulations restrict what information Humana can share about individuals and their medical care” adding that they “…always encourage our members and authorized family members or caregivers to contact us with questions or concerns…” Shortly after NBC6 reached out, Diana heard from Humana. “The representative did call me to tell me that the check is being processed and that I should be receiving something in the next 48 hours,” she said. A few days later, she checked her mailbox. “And I couldn’t believe it,” Diana said. “I saw a Humana envelope.” Inside, she found a check for the remaining $8,800, putting an end to her yearslong wait. “I’m just happy that it got resolved with your help,” she said. “I mean, I really appreciate NBC6.”

Nov 8, 2024 - 01:14
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NBC6 Responds helps woman recover thousands for medical claim reimbursement

Diana Gonzalez is still healing after losing her dad in 2020.

“What happened to my dad was tragic,” she said. “He got sick, he got worse, he got leukemia – that shouldn’t have happened.”

She said her dad had traveled to Colombia during the pandemic and ended up needing medical care during that trip. She confirmed he had coverage through Humana, she said.

“They said, well, you know, since it’s out-of-state coverage, we would pay for it, but you have to pay for it upfront, so I did,” Diana said.

Diana paid nearly $14,000 and later filed a claim for reimbursement, which she said was approved.

“I received three checks, but they were under his name,” she said.

Her father had already died when the checks arrived, so she called Humana and was told they would reissue the checks under her name, she said, since she had the required legal documents. So, she returned the initial checks. When she got one of the new checks, Diana said she called to follow up about the rest.

“It’s in the system,” she said she was told. “It’ll take some time because it has to go through another account.”

That was back in 2021. Diana would spend the next three years calling Humana every few weeks and waiting, before she decided to ask NBC6 Responds for help.

“It was something that was approved and they’re just giving me the runaround,” she said. “I always hear stories that you guys are always on top of things and resolve it. If it can’t be resolved then, you know, I don’t know what else to do.”

NBC6 contacted Humana on Diana’s behalf. They told NBC6, in an email, “…federal privacy regulations restrict what information Humana can share about individuals and their medical care” adding that they “…always encourage our members and authorized family members or caregivers to contact us with questions or concerns…”

Shortly after NBC6 reached out, Diana heard from Humana.

“The representative did call me to tell me that the check is being processed and that I should be receiving something in the next 48 hours,” she said.

A few days later, she checked her mailbox.

“And I couldn’t believe it,” Diana said. “I saw a Humana envelope.”

Inside, she found a check for the remaining $8,800, putting an end to her yearslong wait.

“I’m just happy that it got resolved with your help,” she said. “I mean, I really appreciate NBC6.”

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