Humana Dental
Complaint 7418 Details
- Date Occurred: 07/23/2013
- Reported Damages: $1,436.00
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The complaint is against an online dating profile
The complaint is a listing fraud posted on public forums or sites against an anonymous entity
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The company or person contact no longer exists
International boundaries
An agent from Humana came to my house some time in May 2011 to sign me up for medicare dental insurance for 31.00 per month. I told her i had to have several teeth pulled out and that i needed to get dentures. She 'Leslie Young' the sales representative, to told me that Humana would pay up to $1,500 per year for any dental work. I told her that i would do $1,500 this year and then next year i would do 1,500 more and then cancel my dental insurance, because once i got dentures i would not really need that insurance. she went along with that and yessed me until i got signed up. She knew i needed to pull teeth out and get dentures and she still led me to sign up when i reality she knew that Humana had not intention of paying no $1,500. Today 07/28/2011, i received a cheque form Human dental for $63.90. I was expecting to get this $1,500 and pay for a car i got, plus take a week the take my grandson to see his father, whom he had never met. Now i can't do any of that and i am left $1,500 less when i was betting on it. I want to Sue Humana Dental for miss representation. Please advise.
Comments
- elissavet SBID #N/A
- Posted 07/28/2013
- In addition i will have to charge Humana dental for stess they have caused me, by not honoring what Leslie Young promised me and for my money being tied up to a venture that would not be honored by Humana Dental.
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- jet_setter00 SBID #088c12ee4d
- Posted 08/16/2014
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Let me start by saying I don't work for Humana dental, but do work in the insurance field.
Question: Have you paid the dentist or physician $1500?
If yes, first thing you need to figure out is if that dr/dentist is IN NETWORK or OUT OF NETWORK based on your plan.
If they are in network, then you need to review the statement that Humana dental provided, and look at the max allowable amount that dr/dentist is allow to charge for the service, if you paid the dr/dentist then you have to go to the dr/dentist and request a refund.
Out of network is a lot more tricky, since there is no contract between the dr/dentist and the insurance company discounts and negotiated rates don't get factored in and the dr/dentist can charge anything they want.
Example out of network: If a dr/dentist decides their time and services should be worth $2000 then they expect to be paid $2000. A claim is submitted either by yourself or the dr/dentist office, the insurance company then uses a usuall and costomary rate for which services were provided say (for this example) $1200. that means the insurance would only pay up to the $1200, this then leaving the patient to fulfill the remaining $800 out of their own pocket.
I'd be willing to help more as well usually if you call the customer service number on the insurance card someone should be able to help you, just have them talk or give examples as I have in more detail. Customer service will be able to help find a dr/dentist that is in network for future service, and explain the exact benefits, tell them everything you wrote on what services you'll need, but I'd leave out the part about dropping the coverage once the services were completed ^_- -
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Company Statistics
- Complaint Against Humana Dental
- Complaints Filed: 1
- Reported Damages: $1,436.00
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