Updates on Coverage Policies,
Webinars and Presentations

Medical Coverage Policies for February, March and April

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

  • Acne Treatment
  • Diagnosis and Treatment of Pervasive Developmental
    Disorders (PDD)
  • Occipital Nerve Stimulation
  • Peripheral Artery Stenting
  • Phototherapy and Photochemotherapy for Skin Conditions
  • Tinnitus Treatment

Policies with Significant Revisions

  • Airway Clearance Devices
  • Blepharoplasty
  • Continuous Positive Airway Pressure (CPAP) Devices
  • Epidural Steroid Injections
  • Facet Injections
  • Hyperhidrosis Treatment
  • Intensity Modulated Radiation Therapy (IMRT)
  • Negative Pressure Wound Therapy
  • Outpatient Cardiac Monitoring Devices
  • Oxygen Therapy
  • Prophylactic Mastectomy
  • Speech Therapy
  • Spinal Cord Stimulators
  • Treatment of Varicose Veins

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
Oct. 9 1 p.m. EDT Humana.com Overview Learn how to submit Web requests and inquiries, such as eligibility and benefits, referral inquiries and submissions, claim status, remit inquiries and much more. You will also learn how to perform administrative functions, such as adding new users.
Oct. 23 1 p.m. EDT 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.
Nov. 6 1 p.m. EST Humana.com Overview  
Nov. 11 1 p.m. EST Humana.com - Referrals & Authorizations Learn how to submit and view Web referrals, inpatient and outpatient authorizations/ notifications.
Nov. 20 1 p.m. EST RTCA Overview  
Dec. 4 1 p.m. EST Humana.com Overview  
Dec. 18 1 p.m. EST RTCA Overview  
       
For more information, visit Humana.com.

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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.

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Letter From Bruce Perkins
Updates on Coverage Policies, Webinars
  and Presentations
Hedis® Changes for 2009
Clinical Trials, Category B Investigational Device
   Exemptions (IDEs) and Medicare Studies

Importance of Proper Signatures for CMS Data
   Validation

New Survey to Improve Provider Service
Pharmacy Management Updates
Arterial Venous Fistulas (AVF):
   The Gold Standard for Vascular Access
Humana Offers Resources for Caregivers and
   Advance Care Planning
Humana Committed to Quality Improvement
Clinical Tips for Providers
Faster Service with Claims Update
Safeguarding Humana Members
Ask the Experts
Board Members Needed