11/10/2025

OOS Member Practices Meet with Humana to Reverse Cataract Claim Denials

Earlier this summer, Humana Medicare began denying cataract surgery claims—both professional and facility billing—impacting practices statewide for several months.

In response, OOS requested a meeting with Humana leadership in Ohio to clarify the issue and demand an immediate resolution.

Representatives from Wooster Eye Center, Ohio Eye Associates, and Eye Physicians of Springfield met directly with Humana’s medical directors and the Midwest regional president.

The outcome: Humana agreed to reverse the denials and issue retroactive payments for affected claims.

While other issues remain, this successful advocacy underscores OOS’s commitment to standing up against insurance abuses and protecting ophthalmologists and patients across Ohio.

We thank the participating practices for their time and collaboration.