Submitting Claims vs. Correspondence

To streamline the handling of complex claims inquiries and other general claims correspondence, Humana has dedicated service units in place to research and resolve written correspondence submissions.

In order to help avoid the frustration of the denial of claims as duplicates, providers are asked to attach a cover letter whenever they send correspondence, appeals or inquiries about a claim to Humana. The cover letter should include identifying information related to the claim along with a description of the inquiry. This process of sending a cover letter as the first page, rather than the claim itself being first, will help to clearly identify the materials as correspondence rather than a claim, which will help to avoid duplicate denials.

If corrections are made to a previously submitted claim, clearly identifying the claim as a “corrected claim” in the cover letter will help Humana properly process it.

Another way to avoid duplicate denials is to attach copies of claims submitted with previous correspondence to the cover letter.

Our secure, Self-Service Center on Humana’s Web site offers online tools to help health care professionals, including third-party administrators, streamline administrative tasks, including claims submission. Providers can view this information by visiting www.humana.com. Click on “Providers,” “Provider Resource Center” and then “Claims Submission and Online Tools” from the list on the left.

Inquiries about claims submissions can also be submitted to the address listed on the back of the member’s Humana identification card.

With claims payment systems and correspondence business units dedicated to researching and resolving inquiries to address doctors’ needs, Humana is committed to becoming the nation’s easiest payer with which to do business.