A Humana healthcare Provider doing physical theropy on a patient's knee.

Outpatient Therapy

Speech Therapy, Occupational Therapy and Physical Therapy

Outpatient therapy services are administered by OrthoNet, a provider-based musculoskeletal disease management company that provides a broad range of orthopedic administrative and medical management services. OrthoNet is Humana’s network manager for designated outpatient physical, occupational and speech therapy services.

Precertification, Preadmission, Preauthorization and Notification Requirements

Please note that precertification, preadmission, preauthorization and notification requirements all refer to the same process of preauthorization. However, for Medicare Advantage (MA) Private-Fee-for-Service (PFFS) plans, notification is requested, not required.

Please note: Exclusions from this requirement include the following members and providers:

  • HumanaOne® members
  • Commercial and MA HMO members assigned to a risk-based or delegated independent physician association (IPA) or physician hospital organization (PHO)
  • MA HMO members in Alabama, Florida, Tennessee, Mississippi, South Carolina, Georgia, California, Louisiana and Nevada
  • Kentucky Teachers' Retirement System (KTRS) members enrolled in an MA plan

Submitting Preauthorization Requests

Humana requires that any occupational therapy, speech therapy and physical therapy treatment plans ordered for a Humana-insured patient, including MA Private-Fee-for-Service (PFFS) notification, be administered through OrthoNet using its fax-based request system.

OrthoNet

Fax: 1-800-863-4061

Additional Resources

Humana/OrthoNet Therapy Program for Humana Members

Learn more about this program and the patient information required when requesting preauthorization or providing notification.

Questions

Questions about this program may be directed to OrthoNet’s provider services:

Phone: 1-800-862-4006