A Humana Healthcare Provider on their computer.

Clinical & Healthcare Resources

Use these links to browse provider-specific information such as clinical guidelines and industry resources on the Web.

Preterm Delivery Prevention Program

A preterm delivery prevention program for pregnant women with a history of spontaneous preterm birth at less than 37 weeks of gestation

Program Details
(300 KB) Download PDF
English

Cultural Diversity

Cultural Diversity Program
Learn about Humana's Clinical Disparities and Cultural Diversity (CDCD) program and access helpful links.
(56 KB) Download PDF
English
Multilingual Health Resources
Learn about Humana's multilingual health resources for health care providers and access to helpful links.
(56 KB) Download PDF
English
Humana's Cultural Competency Plan for health care providers
(617 KB) Download PDF
English
Humana's Cultural Competency Plan for South Florida Medicaid health care providers
(622 KB) Download PDF
English

Authorization Management Frequently Asked Questions

Authorization Management F.A.Q
Learn about Humana's authorization management frequently asked questions
(97 KB) Download PDF
English

Download & Print

Comprehensive lists of services requiring preauthorization

January 22, 2011 Medicare Preauthorization and Notification List
(294 KB) Download PDF
English
January 22, 2011 Commercial Preauthorization and Notification List
(273 KB) Download PDF
English
January 24, 2010 Medicare Preauthorization and Notification List
(100 KB) Download PDF
English
January 24, 2010 Commercial Preauthorization and Notification List
(100 KB) Download PDF
English
July 10, 2009 Medicare Preauthorization and Notification List
(228 KB) Download PDF
English
July 10, 2009 Commercial Preauthorization and Notification List
(214 KB) Download PDF
English
December 1, 2008 Medicare Preauthorization and Notification List
(228 KB) Download PDF
English
December 1, 2008 Commercial Preauthorization and Notification List
(214 KB) Download PDF
English
January 15, 2008 Preauthorization & Notification List
(64 KB) Download PDF
English
2007 Preauthorization & Notification List
(54 KB) Download PDF
English
2006 Preauthorization & Notification List
(35 KB) Download PDF
English

Chronic Condition Special Needs Plan

Humana's Anti-Fraud Plan Policy Bulletin
(337 KB) Download PDF
English

Humana Medicare Transitions to Milliman Care Guidelines®

Humana Medicare Transitions to Milliman Care Guidelines®Humana associates already use Medicare National and Local Coverage Determinations and Humana Coverage Determinations as part of Humana's care management process. Soon, Milliman Care Guidelines® will also be used for Medicare plans. Milliman Care Guidelines are evidence-based and provide care guidelines for common conditions. Humana commercial products implemented Milliman Care Guidelines in 2008.

Many health care providers, payers and health care organizations also utilize these guidelines nationally. Using the same guidelines for both commercial and Medicare products helps Humana improve the consistency and efficiency of its care management process.

Related Resources

Contracting Resources

Learn about an online service to help physicians and other healthcare providers more easily and cost-effectively provide required credentialing information to healthcare organizations and health plans.

Health & Wellness

Read about Disease Management, Wellness programs, and other Humana resources that promote healthy behaviors and support the doctor-patient relationship.

Advanced Illness Planning

Humana's Advanced Illness Planning program helps providers utilize resources such as the Robert Wood Johnson Foundation website to improve end-of-life care, guidance and support to members and caregivers for all advanced illnesses.

National Coverage Determinations

Learn about the latest changes the Centers for Medicare and Medicaid Services (CMS) has made to the services that are covered by Medicare.