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Claims Resource Center

Online Claims Submission
Submission of claims through Clearinghouses and Channel Partners
Submitting Claims through the U.S. Postal Service
High Intensity Claims Review Process



. . . If you wish to submit claims through the Web to Humana . . .

For all Non-Florida markets:

www.humana.com offers online claims submission services to its registered providers. This easy-to-use solution has many advantages.
You can:

  • Reduce your administrative workload
  • View user-friendly reports in a timely manner
  • Use easy-to-use claims editing functions
  • Submit Humana claims at no cost to you

Any health care professional that is submitting professional claims and encounters to Humana can use this feature through www.humana.com. Simply follow these steps:

  • Make sure your organization is registered on Humana.com. If you are not registered, click here to begin this process. You will need your organization's Tax I.D. and a printer connection on your PC to complete the registration application.
  • If you are registered but are not your organization's Primary Access Administrator (PAA), have your PAA assign you access to the Online Claims Submission function through the "Assign User Access Rights" link on the Provider Self-service Center menu.
  • Log on to www.humana.com and enter the Provider Self-service Center. On the Self-service Center menu, select the "Submit Claims" link under the heading, "Claims Management and Submission."
  • Follow the prompts on this screen. ZirMed, our service partner, will receive an automated message and will contact you to begin the mapping process for submission of your claims to Humana. You are ready to go!
  • Should you have any questions, contact your Humana Electronic Commerce Coordinator.

For Florida Humana markets:

  • Use Availity, a joint venture between Humana and Blue Cross Blue Shield of Florida. All transactions done with Humana through www.availity.com are FREE to the provider's office. Visit the site to view the demo and self-register or call your local Electronic Commerce Coordinator.





. . . If you wish to submit claims to Humana through an affiliated clearinghouse or channel partner . . .

There are a number of clearinghouse and channel partner resources for submission of your claims to Humana. Select one of them from the table below, and be sure to use the associated Payor Code to submit your claims or encounters.

For questions and information concerning electronic claims submission to Humana Health Plans of Ohio (ChoiceCare Cincinnati), please call 800-543-7158.

CLEARINGHOUSE PAYOR CODE
  HUMANA HUMANA HEALTH PLANS OF OHIO (CHOICECARE CINCINNATI)
  ENS (formerly EDSS)   Claims - 61101
  Encounters - 61102
  Not Available
  McKesson HBOC   2449   Provider proprietary
    McKesson I.D.
  Medifax   Claims - 61101
  Encounters - 61102
  Not Available
  NDC   Claims - 61101   Provider proprietary
        NDC I.D.
  PerSe Technologies   1359000   Provider proprietary
        PerSe I.D.
  ProServices   Claims - 61101   Not Available
  ProxyMed   Claims - 61101
  Encounters - 61102
  Provider proprietary
     ProxyMed I.D.
  SSI Group   Claims - 61101   Not Available
  THIN (The Health Information Network)   Claims - 61101   Not Available
  WebMD - Envoy NEIC   Claims - 61101
  Encounters - 61102
  Not Available
  WebMD - MedeAmerica   Claims - 61101   Not Available
   
CHANNEL PARTNERS INTERNET ADDRESS TELEPHONE
     
Availity - FLORIDA ONLY www.availity.com 1-800-Availity
1-800-282-4548
ZirMed www.zirmed.com 1-877-494-7633
     





. . . If you wish to submit claims to Humana through the U.S. Postal Service . . .

HUMANA HUMANA HEALTH PLANS OF OHIO (CHOICECARE CINCINNATI)
For submission of paper claims, use these addresses:
  Humana Claims Office
  P.O. Box 14601
  Lexington, Kentucky  40512-4601
 
  Humana Health Plans of Ohio Claims Office
  P.O. Box 14600
  Lexington, Kentucky  40512-4600
 
For submission of paper encounters, use this address:
  Humana Claims Office
  P.O. Box 14605
  Lexington, Kentucky  40512-4605
  N/A





. . . if you wish to learn more about Humana's High-Intensity Claims Review Process . . .

Humana reviews the clinical documentation associated with high-intensity evaluation and management claims. You may wish to familiarize yourself with our process by clicking here. High-Intensity Claims Review Process



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