What's New

New features/changes to Humana's Provider Website:

Humana Top Payer
Humana has been recognized as the top payer to do business with in a recent study.

Humana is committed to becoming the best payer with which to do business.  The results of a recent study conducted by athenahealth Inc., a leading provider of services and software to medical groups, and Physicians Practice® magazine confirm our goal is becoming a reality.  We were ranked the top payer among national insurers. We understand the importance of paying providers quickly and accurately.  Our efforts are squarely focused on reducing administrative complexity in the health care system.

We have significantly enhanced our provider Web services, which are key to an efficient, streamlined payment process. For example, providers can now submit claims to Humana via our real-time claims adjudication process.  And, we are working with organizations like the Medical Group Management Association, to realize their goals of administrative simplification and multipayer solutions.

For information about the athenahealth-Physicians Practice® study, click here.

The results were featured in the New York Times and Business Week. For the New York Times piece, click here.

Additionally

Reaching Louisiana Patients – If you are based in Louisiana, we need your help in reaching patients who were displaced by Hurricane Katrina. Please print and post this fact sheet in your office where patients can see it.

Real Time Claims Adjudication (RTCA) - This capability allows a provider to bill for services at the "point of service." A fully adjudicated response is returned from Humana, detailing the total charge submitted, allowable charges, as well as the patient's responsibility.

Provider Medicare Information – Obtain more information about plans offered in your area.

Humana Remittance Advice Code Descriptions – The attached document provides a comprehensive list of Humana's Remittance Advice Codes and Descriptions.

Resources for your Humana-insured patients – Learn more about services that can benefit your patients with Humana plans.

Web Based Training and Demo – Humana.com users can now use this Demo to help guide them through functionality on Humana.com.

PAA Welcome – Newly registered Humana.com users will now have a place to go and learn more about what is available to them on the web site.

Smart Summary – The SmartSummary statement is the industry’s first comprehensive and personal, consumer-focused health benefits budgeting, planning and reporting document. Humana members receive their SmartSummary statement quarterly. View a sample of what they receive.

SmartSummary Rx - In a slightly different format and delivered on a monthly basis, SmartSummary Rx offers many of the same benefits of the SmartSummary statement to Humana's Medicare members. Click here  for more details about SmartSummary Rx or here  for a sample of the statement.

Paymentech – Humana is pleased to introduce a new program created exclusively for Humana and Humana ChoiceCare Network participating providers that is designed to help reduce credit card transaction fee costs for your practice. Through this new program, created by a Humana and Chase Paymentech Solutions, LLC partnership, your practice can accept credit cards at significantly discounted processing rates.

Preauthorization and Notification List – Comprehensive list of services requiring preauthorization.

Business Function Realignment – Humana.com Primary Access Administrators will now find it easier to give their associates access to secured business functionality.  These functions within the “Administration” area are now listed in a more user friendly format.

How to Access: Login to Secure Portal, Select Assign Web Access Rights in the Administration Panel

Link from Secure Portal to the Provider Resource Center – Humana.com users will now have the capability to access the Provider Resource Center from their secure menu, without logging out of the secure portal.

How to Access: Login to the Secure Portal, the link will appear in the Information Center Panel

Provider Resource Center Redesign – Humana.com users will now find a more efficient and user-friendly website for their use.  Information includes referral/authorization resources, network/market information, e-tools and resources, Humana.com training information and much more.

National Provider Identifier (NPI)    - The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated that all providers use a standard unique identifier on all standard electronic transactions.  The use of the National Provider Identifier (NPI) is mandated on all HIPAA-standard electronic transactions by May 23, 2007.

For information about NPI, or other HIPAA standards, visit http://www.cms.hhs.gov/hipaa/hipaa2. This site provides information related to NPI and other HIPAA standards. At this time, Humana is not requiring providers to submit their NPIs.  Please check back for updates.

Frequently Asked Questions (FAQs)