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.

Taylor Langlois · Answer

Great question. The first thing I would say is don't pay that bill yet. If Humana pre-approved the test, I would simply call them back and ask them to reprocess it using the original authorization reference. A lot of times, bills go out before the approval even gets matched to the claim.

Since it's also been over a week with no callback, I'd ask for a supervisor when you call back in, and still request that escalation. Specifically request a grievance with Humana's grievance department. You can also file a formal written appeal, which does require a written decision from Humana within a certain period.

Through all that, if you're still stuck, I would also say call good old 1-800-Medicare and file a formal complaint as well.

The bottom line though: don't pay yet, document everything, and appeal it in writing, as well as filing a grievance both with Humana and also with 1-800-Medicare.

Chris Smith · Answer

Typically these situations are due to provider filing issues, I would not pay it until they attempt to re-file the claim.  Humana can tell you exactly why your claim wasn't paid if you press them. 

If you are on a Medicare supplement, make sure the provider has filed Original Medicare first, then your Humana supplement. If not, ask them to re-file. 

If you have Humana Medicare Advantage plan, call the provider or hospital and ask a supervisor double check that the claim was filed correctly with the proper coding. Request that they re-file the claim.  

If you need to file a complaint, you can call Humana customer service using the number on the back of your card.

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

Jeff Leichter · Answer

The best practice when you get a medical bill is to call your insurance company with the bill in hand. Over the last ten years, I’ve seen that about 90% of billing problems come down to coding errors or simple mistakes. I’ve called support with my clients many times, and the insurance company will usually reach out, settle the claim, or verify whether the cost is accurate.

Most of the time, the issue isn’t the care you received — it’s your plan design. If you have a high deductible, coinsurance, or copays, those out‑of‑pocket costs can stack up fast. That’s why I recommend adding a hospital indemnity plan to help cover those expenses and give you a financial buffer when you need it most.

Jeff Leichter
Independent Agent with Health Markets.

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

Mel Stevens · Answer

The test was pre-approved but that does not indicate that everything is covered with just a c-pay. When we receive testing services or many services like medication administered at a facility or a doctor office then we are subject to the Part B 20% Co-insurance. In this case I'm sorry but more than likely you will be responsible to pay your portion of the bill. That being said, it's always worth an inquiry. Perhaps you might be able to save some money. Often times procedures are coded incorrectly the doc office or facility.

Answered by Mel Stevens on August 10, 2026

Broker Licensed in AZ

Answered by Mel Stevens 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.

Matthew Feir · Answer

I'm not currently representing Humana as they don't have any plans available in our area. For help with claims and possibly appealing your claim, you will need to talk direclty with them by calling the phone number on the back of your ID card.

Answered by Matthew Feir on August 3, 2026

Agent Licensed in ND, MN & SD

Answered by Matthew Feir Medicare Insurance Agent

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

Nancy Vukovich · Answer

Hi, you can call and check in. This would be my first step. If not a sufficient answer, you can log in to your Humana portal and see if there is an update there as well. If you want to file a complaint, you can contact.

Answered by Nancy Vukovich on July 20, 2026

Broker Licensed in IL & IN

Answered by Nancy Vukovich Medicare Insurance Agent

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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