Quick Addendum to the previous entry:
I have been on the phone with Humana reps for about the last 40 minutes. While I may be frustrated with their policies and all the hoops we are having to jump through, I have to say that their customer service representatives are top-notch. They have been very helpful and the one person I have been working with most closely has gotten other people on the line and has actually given me the direct number of the head of her department to contact if needed. These are definitely not the people who are trying to "screw us over".
Here is the latest on where things stand:
MCV hospital IS in network for medical care. What I don't know (yet) is if Hem/Onc (specifically Dr. Khan) bills under the same Tax ID. If so, part of our problem is solved. If not, we have a few options:
1. We can see if Dr. Khan can bill through MCV's tax ID (some hospitals can do this, others can't).
2. We can have Dr. Khan get in touch with Provider Affairs to be "in network" and have him date the start of his "contract' with them to be the date he began care for Charlotte. This could be a lengthy process but could be approved while she is undergoing chemo and if they backdate the contract, it will be covered
3. We can accept that we are "out of network" and then file a grievance. This is how we get the insurance company to pay for an "out of network" doctor. Another 60 day process for an appeal but in the meantime she can receive treatment.
4. If MCV/Oncology is in network but stem cell is still out of network, we can do #3 just for the stem cell part and see if we get approval.
5. OR we can just pack up and go to an in network hospital for everything (or just for the stem cell part).
I will be talking in depth with the doctor tomorrow to see what our options are.
Meanwhile, I can't imagine what families who don't have the knowledge or time or energy to fight this stuff and/or ask the right questions do in situations like this. It boggles the mind!