Preauthorization and Notification
Radiation therapy services were recently added to Humana’s commercial and Medicare Advantage (MA) Preauthorization and Notification lists. These services are administered by HealthHelp, a nationally recognized radiology benefit management organization. Please note that precertification, preadmission, preauthorization and notification requirements all refer to the same process of preauthorization.
Effective July 10, 2009, Humana began using RadConsult™, HealthHelp's service for obtaining preauthorization or submitting notification, for Humana-insured patients' radiation therapy.
Please note: Exclusions from this requirement include the following members and providers:
- Puerto Rico commercial and MA members
- Florida MA HMO members
- Ochsner commercial and MA HMO members
- Health Care Partners MA HMO members and Chicago risk and delegated providers
Submitting Preauthorization Requests
Humana requires that any radiation therapy treatment plans ordered for a Humana-insured patient, including MA Private-Fee-for-Service (PFFS) notification, be administered through the RadConsult call center or by submitting an online request.
These new preauthorization and notification requirements apply to two-dimensional (2D) and three-dimensional (3D) conformal radiation, intensity-modulated radiation therapy (IMRT), brachytherapy, stereotactic radiation therapy and proton-beam procedures.
RadConsult call center
Monday - Friday from 7 a.m. to 7 p.m. Central Time
Saturday from 9 a.m. - 4 p.m. Central Time
Submitting a request online
Physicians may submit an online request via HealthHelp
- Humana Radiology Benefit Management
- Learn more about this program and the patient information required when requesting preauthorization or providing notification.
- (267 KB) Download PDF
Learn how to request, schedule and follow up on imaging services and treatment plans for your Humana-insured patients online with RadConsult by viewing the Education on Demand presentation, RadConsult Online
Questions about this program may be directed to HealthHelp's RadConsult program support:
By Phone: 1-800-546-7092
Monday – Friday: 7 a.m. – 7 p.m. Central Time
Saturday: 9 a.m. – to 4 p.m. Central Time
By E-mail: firstname.lastname@example.org