Humana Expands Electronic Medicare Filings

Feedback from employer groups that include senior citizens who are covered by Humana insurance is sparking changes in the way that network providers submit Medicare claims data to Humana.

Providers submitting claims on behalf of Humana’s Medicare-eligible members will submit claims to Medicare, and Humana will obtain claims information electronically from Medicare, eliminating the need for providers to submit a second claim to Humana.

This change will be effective in all Humana locations by the end of the second quarter.

“This expanded functionality by Humana will simplify processing for more than 85 percent of the claims that providers file on behalf of patients with Medicare as the primary payer,” said Pamela Wilson, director of Claims Operations for Humana.

Currently, providers who serve Medicare patients file two separate claims — one with Medicare and another with Humana — electronically or by paper. In the future, providers will continue to file with Medicare, but they will not be required to file a second claim with Humana.

“Employer groups were asking for this change, particularly those with significant numbers of retirees or people working beyond the Medicare eligibility age,” said Wilson. “As Humana looks for new ways to serve the senior market, this innovation offers added convenience for our providers and members.”

If you have any questions about this change, contact Humana Customer Service.

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