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Electronic Claim & Encounter Submission


Humana not only accepts, but also encourages providers to submit their claims electronically. Depending on the provider's claim volume, submitting electronically could significantly decrease an office's administrative cost and improve cash flow.

Providers have a number of options for submitting claims electronically. While Humana has identified Availity LLC as our central gateway for EDI transactions, providers can still submit to a variety of clearinghouses (see below). Visit www.Availity.com to get more information about direct claim submission.

Humana.com, through a relationship with ZirMed, can also support your electronic submission needs. Registered users can access the "Claim Management Center" within Humana.com's self service center and submit Humana claims at no cost to the physician or provider. Register to use the Self-service Center.

Can't generate an electronic claim file? Humana also has options for providers who want to submit electronically, but can not generate an electronic billing file. Contact your Humana connectivity consultant for assistance.

Clearinghouse  Web Address

Payor IDs

Phone
Claims 
Encounters
Availity www.availity.com 61101 61102 (800) 282-4548
ENS www.enshealth.com 61101 61102 (800) 341-6141
McKesson www.mckesson.com 2449 61102 (800) 482-3784
Medifax www.medifax.com 61101 61102 (800) 819-5003
Nebo www.nebo.com 61101 61102 (866) 810-0000
NDC Health www.ndchealth.com 61101 61102 (800) 778-6711
PerSe www.per-se.com 1359000 61102 (877) 737-3773
Proxymed www.proxymed.com 61101 61102 (800) 882-0802
SSI Group www.ssigroup.com 61101 61102 (800) 881-2739
THIN www.thinedi.com 61101 61102 (972) 766-5480
WebMD www.webmd.com 61101 61102 (877) 469-3623
ZirMed www.zirmed.com 61101 61102 (877) 494-7633
Evertec (Puerto Rico only) www.evertecinc.com 61101 61102 (787) 474-6000
Inmediata (Puerto Rico only) www.inmediata.com 61101 61102 (809) 540-6612

Please be aware that some electronic claims clearinghouses and vendors charge a service fee. For more information, please contact the clearinghouse/vendor or your assigned electronic commerce consultant or send e-mail to deployment@humana.com.



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