Web-based Authorization Submission Available

Humana's commitment to simplifying communications and transaction management with physicians and facilities takes on a new dimension this spring with the addition of Web-based authorization inquiries and submissions. The online function enables physicians and facilities to electronically submit all authorization requests for (and notifications of) inpatient admissions, as well as requests for outpatient services that require prior authorization.

The new capability, available 24 hours a day, is expected to save time for physician offices and facilities. Users will receive an almost instantaneous response. In addition, the Web process is designed to work with all platforms, a substantial simplification for providers who have members in a variety of Humana plans.

"For physicians and facilities, this new Web function means they'll have just one point of contact for a wide range of Humana products," said Lisa Weaver, M.D., vice president of Health Systems Support. She noted that the system is structured to handle multiple functions, such as referral submission, or referral and authorization inquiry, when required, enabling users to conduct and complete several transactions in a single session at their convenience. "This enables the office or facility staff to process the submissions on their time, without having to call or be tied to the telephone," Weaver added. Following are other benefits of the new function:

  • Almost instant response, advising users that the authorization has either been approved or is pended for review
  • Extensive search features, enabling users to look up diagnosis codes or identify participating facilities and providers

Facility staff who have been using the new feature since it became available have cited several work-flow improvements, including no time spent waiting on the phone to obtain approvals and the ability to access other www.humana.com online functions and features without logging out of the system.

The authorization submission function can be accessed through www.humana.com or through www.availity.com for Florida physician offices. (Availity is a joint-venture between Navigy Inc., a wholly owned subsidiary of Blue Cross and Blue Shield of Florida, and HUM-e-FL Inc., a Humana subsidiary.)

Physicians and facilities that are not currently using the growing number of Web-based transaction functions are encouraged to register at www.humana.com. Those who require assistance with the registration process should call their Humana electronic coordinator.

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Humana Drug List Offered Through ePocrates

As part of an initiative intended to help physicians streamline the prescribing process for their Humana patients, physicians who use personal digital assistants (PDAs), such as Palm™ handheld devices, can now instantly access Humana's Drug List — in the office, the exam room or other off-site locations. Humana has entered into an arrangement with ePocrates, the company that operates the largest network of physicians using handheld devices, to include Humana's Drug List in its drug reference guide.

"ePocrates offers our participating physicians a convenient way to look up Humana's Drug List without leaving the exam room," said Cheri Elmore, Pharm.D., a Humana clinical manager and pharmacist. Elmore adds that Humana's Drug List will be updated routinely, which should reduce the amount of time physicians spend returning pharmacy calls and making patient inquiries. There is no charge to the physician for accessing the system.

The ePocrates system, used by many insurers and a growing number of Medicaid programs, gives users access to up-to-date formulary information through the ePocrates Rx™ application, as well as a broad range of clinical drug-related safety and comparison data on more than 2,600 drugs. For example, the software enables physicians to conduct quick, easy reference checks on several aspects of prescription drug prescribing, including:

  • information on generic alternatives to brand-name drugs;
  • listings of potential adverse drug reactions for patients on more than one medication;
  • lower-cost therapeutic alternatives for a wide range of drugs;
  • dosage recommendations for both adults and pediatric patients and
  • continually updated clinical data, including FDA drug safety alerts.

Now used by more than 250,000 U.S. physicians, ePocrates has received favorable reviews from many health professionals for its ability to improve work flow. In addition, leading clinical publications, such as Journal of the American Medical Association, have cited the software's many prescribing-management, cost-reduction and patient-safety improvement features. The software is designed for handheld devices that use the Palm operating system, including Handspring™, Kyocera™ and Sony™.

For more information on Humana's Drug List and to obtain a free download, go to www.humana.com or visit the ePocrates Web site at www.epocrates.com.

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