tl;dr: How can we “divorce” Humana? And why won’t they let us?
Background: So my sister (in FL) has been in the ICU for 3 months because a home nurse dropped her out of bed. Prior to that she had (more or less) 24/7 home nursing care (one RN and typically one CNA), paid for by Medicare/Medicaid. We’ve desperately been trying to get her home, but she can’t be discharged unless home nursing care is in place. And Humana has been stalling and deceiving us the whole time.
Current situation: After escalating things to a dual AHCA complaint (one by the family, the other by the hospital), we’re finally getting traction on dumping Humana for one of the two other available providers. Both of those providers pay more than Humana to RNs and CNAs, and have staff available through their contracts (which Humana demonstrably does not). We also have approval from AHCA to transfer providers, even though the typical enrollment period is in November. But Humana is still negotiating with us about what they now say they’re willing to provide, and effectively is blocking our leaving them for one of the other providers.
Questions: Most importantly, what else can we do to make Humana let us leave them? Secondly, more out of curiosity, why would Humana even want to remain my sister’s provider when we’ve been providing them so much grief (via the AHCA complaint, as well as through months of internal escalation within Humana)?
TYIA
submitted by /u/nonnonplussed73
[link] [comments]tl;dr: How can we “divorce” Humana? And why won’t they let us? Background: So my sister (in FL) has been in the ICU for 3 months because a home nurse dropped her out of bed. Prior to that she had (more or less) 24/7 home nursing care (one RN and typically one CNA), paid for by Medicare/Medicaid. We’ve desperately been trying to get her home, but she can’t be discharged unless home nursing care is in place. And Humana has been stalling and deceiving us the whole time. Current situation: After escalating things to a dual AHCA complaint (one by the family, the other by the hospital), we’re finally getting traction on dumping Humana for one of the two other available providers. Both of those providers pay more than Humana to RNs and CNAs, and have staff available through their contracts (which Humana demonstrably does not). We also have approval from AHCA to transfer providers, even though the typical enrollment period is in November. But Humana is still negotiating with us about what they now say they’re willing to provide, and effectively is blocking our leaving them for one of the other providers. Questions: Most importantly, what else can we do to make Humana let us leave them? Secondly, more out of curiosity, why would Humana even want to remain my sister’s provider when we’ve been providing them so much grief (via the AHCA complaint, as well as through months of internal escalation within Humana)? TYIA submitted by /u/nonnonplussed73 [link] [comments]Read Morer/HealthInsurance