Physicians and providers who wish to bill electronically, but cannot generate an electronic claim file, do have resources to convert existing files into Health-Insurance-Portability-and-Accountability-Act (HIPAA)-compliant electronic submissions. Contact your Humana e-business consultant at firstname.lastname@example.org for assistance.
Claims Submission Time Frames
Health care providers are encouraged to take note of the following claims submission time frames for Medicare Advantage and commercial claims:
|Plan ||Claims Submission Time Frame |
|Medicare Advantage ||Claims must be submitted within one calendar year from the date of service. |
|Commercial ||Claims must be submitted within the time stipulated in the provider agreement or the applicable state law. |
Generally, these claims must be submitted within:
- 180 days from the date of service for physicians
- 90 days from the date of service for facilities and ancillary providers
Billing Guidelines for Roster Bills Submitted On Paper Claims
Physicians and health care providers should follow the billing guidelines below when submitting roster bills to Humana:
- Physicians and health care providers may submit multiple documents in a single large envelope.
- Documents may include information regarding multiple patients.
Instructions for Submitting Roster Bills:
Physicians and health care providers may submit CMS 1500 forms or UB04 forms with an attachment listing multiple patients receiving the same service. The claim form should have the words "see attachment" in the "Member ID" box.
Please send roster bills to the following address:
P.O. Box 14601
Lexington, KY 40512