Updates on Coverage Policies,
Webinars and Presentations

Medical Coverage Policies for November, December and January

Humana’s medical coverage policies are based on evidence published in peer-reviewed medical literature, technology assessments obtained from independent medical research organizations, evidence-based consensus statements and evidence-based guidelines from nationally recognized professional health care organizations.

Information about medical coverage policies can be found on Humana.com. After entering the provider area, click on “Tools & Resources,” “Provider Tools” and then “Clinical and Healthcare Resources.” Choose “Medical Coverage Policies.” The medical coverage policies can be reviewed by name as well as revision date. You may also search for a particular policy using the search box. More detailed information may be found by reviewing “How to read a medical coverage policy” and “Understanding the Process.”

Below are new and revised polices:

New Policies

  • Clinical Trials — Coverage of Routine Patient Costs
  • Cognitive Rehabilitation
  • Oral/Dental Appliances for Obstructive Sleep Apnea
  • Osteochondral Autograft Transplant

Policies with Significant Revisions

  • Bariatric Surgery
  • Biofeedback
  • Cardioverter Defibrillators
  • Durable Medical Equipment
  • Electrical Stimulators for Pain
  • Lymphedema Treatment
  • Neuromuscular Stimulators
  • Outpatient Cardiac Monitoring Devices
  • Surgical Treatment of Obstructive Sleep Apnea
  • Vagus Nerve Stimulation
  • Ventricular Assist Devices

Webinars Provide Interactive Learning

Humana offers interactive Web-based training sessions for its providers twice a month.

To register, send an e-mail to deployment@humana.com.

Below is a listing of upcoming Webinars: Please note times are Eastern Time.
Date Time Topic Description
July 17 1 p.m. ET Humana.com Overview Learn how to submit Web requests and inquiries, such as eligibility and benefits, referral inquiries and submission, claim status,remit inquiries and much more. You will also learn how to perform administrative functions, such as adding new users.
July 31 1 p.m. ET RTCA Overview What is Real-Time Claim Adjudication (RTCA)? Learn how to get your claims fully adjudicated in less than a minute and collect the patient's share at the time of service.
August 14 1 p.m. ET Humana.com Overview  
August 19 1 p.m. ET Humana.com - Verifying Eligibility & Benefits How to verify patient's eligibility and view detailed benefits information; perform single or multiple inquiries.
August 28 1 p.m. ET RTCA Overview  
Sept. 11 1 p.m. ET Humana.com Overview  
Sept. 25 1 p.m. ET RTCA Overview  
Oct. 9 1 p.m. ET Humana.com Overview  
Oct. 23 1 p.m. ET RTCA Overview  
Nov. 6 1 p.m. ET Humana.com Overview  
Nov. 11 1 p.m. ET Humana.com - Referrals & Authorizations Learn how to submit and view Web referrals, inpatient and outpatient authorizations/ notifications.
Nov. 20 1 p.m. ET RTCA Overview  
Dec. 4 1 p.m. ET Humana.com Overview  
Dec. 18 1 p.m. ET RTCA Overview  
       
For more information, visit Humana.com.

 


Back to top

Presentations Seek to
Make Your Job Easier

Humana’s “Education on Demand” tool provides you and your office staff with quick, easy-to-understand presentations on topics that should make it easier for you to do business with us.

To access any of these presentations, visit the provider area of Humana.com by clicking on “Provider” on the main page. Then click on “Tools & Resources,” “Provider Tools,” “Education” and finally “Education on Demand.” If your computer does not have a sound card or is not configured for streaming audio, you can listen to these presentations over the telephone while viewing the slides on your screen. To begin the telephone playback process, click on the question mark in the bottom right corner, select “Player Settings” from the pop-up box and check “Use telephone playback with standard player.” Next, click the “Submit” button and a window will open displaying the telephone number and access code that you need to dial to receive the audio.

Available presentations are as follows:

  • Online Prior Authorization Tool
  • HumanaAccessSM Visa® Debit Card
  • RadConsult Online
  • SmartSummarySMRx

The presentations are available on our  Internet site so they can be accessed around  the clock at your convenience.

Back to top

 



Letter From Bruce Perkins
Updates on Coverage Policies, Webinars
  and Presentations
Eight Humana Policies You Should Know
Humana Begins Standardizing Network Infrastructure
Humana Expands Laboratory Options for
   Providers, Members
Clinical Tips for Providers
Humana Offers Special Needs Plan for Osteoarthritis
Enhanced Benefits for Humana Active Outlook in 2008
Humana Encourages Use of Mail-Order
   with RightSourceTM
ICD-9-CM Coding for Heart Failure
Pilot Project Test-Drives 'Medical Home'
Use of NPI is Now Mandatory
Ask the Experts