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Wellcare vs Humana Gold HMO...


Best answers
I have a pt who had surgery at the end of Dec 2011 and was covered by Wellcare HMO ins; pt returned for a f/u visit included in the global in Feb 2012 and now has new coverage w/Humana Gold HMO; eff 1.01.12. My question is: who is responsible if there are any charges (ie xray) on the f/u visits? Any help would be greatly appreciated, thx :confused:


True Blue
Baton Rouge
Best answers
The new policy that is effective 1-1-12 would be responsible. The fact that the patient just had surgery isn't relevant. Current charges fall under new policy, so thats where the claim should go.

Hope this helps! :)