Providers have a number of options for submitting claims electronically. While Humana has identified Availity®, LLC as our central gateway for electronic data interchange (EDI) transactions, providers can still submit to a variety of clearinghouses (see below).
Visit Availity.com to get more information about direct claim submission.
Provider Self-Service Center
Humana.com, through a relationship with ZirMed®, can also support your electronic submission needs. Registered users can access, at no cost to the physician or provider, the "Claim Management Center" and submit Humana claims within Humana.com's self-service center.
Explore the Provider Self-Service Center
Can't generate an electronic claim file?
Humana also has options for health care providers who want to submit electronically, but cannot generate an electronic billing file. 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
Federal H.R. 2851 "Michelle's Law"
View information about continued coverage for full-time students who are on medical leave of absence.
In addition to Michelle's Law, the federal Patient Protection and Affordable Care Act contains provisions requiring health plans currently covering dependent children to continue to make such coverage available for an adult child until the child turns 26 years of age regardless of student status. For more information on the federal Patient Protection and Affordable Care Act, please click on the link below
- Federal H.R. 2851 "Michelle's Law"
- (19 KB) Download PDF
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