I’m on Humana Medicare. Customer service pre-approved a nuclear stress test, but I just got a $780 bill. They escalated it over a week ago and never called back. Do I have to pay? How do I file a complaint?

Question

Mark Bilgere · Accepted Answer

Call the Customer Care number on the back of the Humana member ID card. Or, you may file an appeal online at HUMANA. Make sure you have the following information. 
Humana ID card
Provider bill
Humana EOB
Date of service
Claim number
Provider name and NPI, if available
Amount billed
What the client believes is wrong
Any notes from calls with Humana or the provider

Make sure to indicate that it is an appeal of payment or a coverage decision.

If HUMANA can't resolve the issue, you can call 1-800-MEDICARE. Tell Medicare you have already filed the billing complaint with HUMANA, it has not been resolved to your satisfaction, and you would like to know what your next steps are.

Ann Sanfelippo · Answer

You do not necessarily have to pay the bill just because you received it. First, ask the provider whether the claim has been processed and whether the $780 is your final responsibility or is still under review. If Humana pre-approved the test, request a copy of the authorization and ask for a written explanation of why the claim was denied or why you owe the balance.

If you disagree with the decision, you have the right to file an appeal with Humana and request an expedited review if appropriate. If you're unable to resolve the issue, you can file a complaint with 1-800-MEDICARE or your state's State Health Insurance Assistance Program (SHIP) for assistance. Keep records of the authorization number, names of representatives you spoke with, and all correspondence to support your appeal.

Jamie Hindley · Answer

There could be a few things happening here. The bill might have crossed in the mail before a payment was made by Humana or the test might have been done out-of-network. It is also important to know that a pre-approval from Humana just means they agreed the test was medically necessary, not that they pay 100% of it and you will still have a cost-share for that test. Depending on your plan, that $780 might be your deductible or co-insurance. I would call Humana and ask specifically for the claims department and ask them how the claim was processed. If you are still not happy, you can file a complaint with Humana or submit a claim through medicare.gov if you think you are being unfairly charged.

Answered by Jamie Hindley on July 9, 2026

Broker Licensed in AZ, AK, AL & 18 other states

Answered by Jamie Hindley Medicare Insurance Agent

Katie Hutchison · Answer

You can go to Humana, go to the bottom, on the right side under Member Services, click on Complaints and Appeals. There you can file a complaint or a grievance about your situation. You can also call Customer Support and ask them why the charges are so high.

Answered by Katie Hutchison on July 8, 2026

Broker Licensed in OK

Answered by Katie Hutchison Medicare Insurance Agent

Jennifer McDonnell · Answer

You could contact Humana Customer Service and provide them with the documentation that shows it was 'pre-approved' and ask them to escalate the payment process.

Also, it' possible the medical center forgot to submit the bill to Humana and is expecting you to pay it.

Thomas Brady · Answer

No . I worked for Humana for 4 and half years and I had enough of seeing situations like that constantly. Ridiculously long hold times on customer service when you have questions, I’ve seen and done presentations that were at facilities that were supposed to be in network, but were not in network. They have been doing this for years I would try to find better carriers , with better personalized customer service . Glad you asked that question.

Answered by Thomas Brady on July 9, 2026

Broker Licensed in PA

Answered by Thomas Brady Medicare Insurance Agent

Taylor Langlois · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/humana-medicare-nuclear-stress-test-bill-complaint#taylor-langlois

I’m on Humana Medicare. Customer service pre-approved a nuclear stress test, but I just got a $780 bill. They escalated it over a week ago and never called back. Do I have to pay? How do I file a complaint?

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I’m on Humana Medicare. Customer service pre-approved a nuclear stress test, but I just got a $780 bill. They escalated it over a week ago and never called back. Do I have to pay? How do I file a complaint?

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