3 On Your Side

Phoenix woman says insurance company merged two people's files

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Lisa Smith says she's a victim of a medical information mix-up (Source: KTVK) Lisa Smith says she's a victim of a medical information mix-up (Source: KTVK)
Humana gave generic statement about medical information mix-up (Source: KTVK) Humana gave generic statement about medical information mix-up (Source: KTVK)
Lisa Smith asks 3OYS for help about medical information mix-up (Source: KTVK) Lisa Smith asks 3OYS for help about medical information mix-up (Source: KTVK)
(3 ON YOUR SIDE) -

For Lisa Smith, her middle initial has never been more important.

"I am Lisa Gaye Smith," Smith said. "That's a 'G' middle initial."

But she said try telling that to the insurance giant Humana.

It all started a few months ago when Smith was online looking for insurance coverage and found herself applying to Humana.

"I liked the coverage," she told 3 On Your Side. "I loved the premiums. I liked that Humana was a big name."

But not long after her coverage began, Smith said she got a phone call from Humana.

"I get a call from Humana wanting to know more about my Medicare and I'm like, 'I'm not on Medicare,'" Smith said.

Smith said that didn't sound good at all. It got worse when she went to a recent doctor's appointment and her medical file contained all kinds of strange prescription drugs that she's never taken before.

"These are not your prescriptions?" 3 On Your Side asked as we reviewed a list of prescriptions.

"They are not my prescriptions, ever." Smith said. "I have never taken any of these."

Turns out, Lisa G. Smith said Humana mistakenly merged her medical file with a Lisa T. Smith who lives in another state.

She's called Humana numerous times and has notes and dates documenting her complaints.

Yet she said Humana won't clear up the problem.  As a result, the two merged files have led to billing problems for the two Lisa Smiths.  In fact, Smith said she found that out on a recent trip to a scheduled doctor's appointment.  She said the doctor's office demanded that she pay $200 in cash and upfront because of constant billing problems involving two different Lisa Smiths.

3 On Your Side got involved and asked Humana to look into the matter and they sent us a generic statement that said, "Protecting our members' privacy is an important priority and we work as quickly as possible to alleviate their concerns."

The statement also said that company will be "making any necessary updates in our systems."

Humana failed to explain how or why this problem happened.  They also avoided discussing exactly how they plan to resolve the issue.

Smith said the issue better be resolved by Humana soon because having two people's files merged as one could spell trouble.

"This could kill one of us," Smith said.

3 On Your Side plans on airing an update on this matter in the near future.

Copyright 2016 KTVK (KPHO Broadcasting Corporation). All rights reserved.


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