One of the nation's largest health insurance companies will refund more than $600,000 to Missouri health care providers, under a settlement with the state Department of Insurance. John M. Huff, Missouri's insurance director, today announced that Humana Insurance Co. and Humana Health Plan LLC will make the payments after improperly collecting refunds from doctors and other providers.
Missouri law allows up to one year for health insurance companies to correct errors in claims processing. A comprehensive investigation by the department's Market Conduct Section found that Humana frequently sought reimbursement from providers more than a year after claims were paid.
"Many doctors in Missouri are small-business owners, and they need to know promptly if there's a payment error," said Huff, director of the Missouri Department of Insurance. "That's why Missouri law gives health insurers no more than one year to make these calculations and bring providers the finality they need."
The department's investigation and Humana's internal review found 1,052 improper reimbursements to 247 health care providers across Missouri. Under the settlement, Humana is required to reimburse the providers $608,642 for improperly collected refunds.
