reimbursement - Humana

[phillips]

Recently (Friday of this past week) my mother was informed by her insurance provider, Humana, that they have denied coverage for the hyperthermic chemotherapy surgery due to "insufficient scientific evidence demonstrated with improved outcomes..." and the surgery has been "determined to be not medically necessary for her condition..." My mother was diagnosed with appendix cancer - signet ring in January. She has had 6 months of chemo and is now ready for the IHPC. I have reached out to her doctor and am awaiting guidance. In the meantime, I wanted to reach out to the group to see if anyone else has had a similar experience and how it was handled. In other words, how did you get your insurance company to approve payment?

Thank you.