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Humana Consolidating Mail to Health Care Providers
Over the next several months, physicians and other health care providers may notice that Humana is changing the way it delivers paper remittance advice notices.
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Medical Records Management
Medical records management enhancements are available on the secure provider web site at Humana.com
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Claim Code Edits Clarified
Humana has further clarified the following claim code edit that became effective for all fully insured commercial members on April 10, 2011
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Changes to Home Medical Equipment Provider Network
Humana has established a long-term relationship with Apria Healthcare, making Apria our provider of choice for Humana members’ home medical equipment needs.
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Code-editing for Medicare-Advantage Plans
Humana Updates Code-editing Software for Medicare Advantage Plans
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Members Can Now Choose a Primary Physician
Humana’s MA PPO and PFFS plans give members the option to name a "primary physician."
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Prepare Now for Transition to Version 5010 and ICD-10
Learn more about Humana's readiness plan and find answers to your frequently asked questions for 5010 and ICD10
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Jan 23, 2012, Claim Code Edits
A list of modifications to Humana's claims payment policies.
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Jan 31, 2012, Facility Claim Code Edits
View updates to our claim payments systems.
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Changes to 2012 Formularies
Beginning Jan. 1, 2012, some Humana members’ medications will have changes under the Humana commercial and Medicare formularies for the 2012 plan year.
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Humana Electronic Tools Designed to Heal the Claims Process
November is the American Medical Association’s (AMA) Heal the Claims Process™ month. Humana can help physicians and participants in the health care claims process to streamline their administrative processes in order to help eliminate administrative waste.
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Flu Vaccine Guidance
2011 Centers for Disease Control and Prevention (CDC) guidelines advise that all individuals over six months of age should receive the flu shot regardless of health status.
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Humana’s Reader’s Digest Healthy Living Plans
Humana and Reader’s Digest have teamed up to offer simple new Medicare Advantage and Medicare Supplement plans.
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Valid NPI Required on All Submitted Claims/Encounters
To satisfy a requirement by the Centers for Medicare & Medicaid Services (CMS), Humana must begin receiving provider claims/encounters data with a valid National Provider Identifier (NPI) as soon as possible and no later than the end of November 2011.
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Compliance Requirements for Health Care Providers
The Centers for Medicare & Medicaid Services (CMS) mandates that all Humana-contracted entities, including those contracted with Humana subsidiaries, complete compliance requirements.
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835 Remittance Advice Transaction
Humana has upgraded the 835 remittance advice transaction to the v5010 standard.
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April 24, 2012, Claim Code Edits
View updates to our claim payments systems.
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Potential Drug-to-Drug Interactions
Health care providers may soon notice an increase in communications from Humana regarding potentially problematic combinations of medications.
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Enhanced Secure Messaging Tool
A new secure message tool is available for health care providers who access secure emails via Humana.com’s secure provider website (registration required).
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Eligibility and Benefits
Learn more about recent enhancements to the E&B web tools
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Claims Attachment Tool Enhancement
Learn more about recent enhancements to our claim attachment web tool
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Referral and Authorization Tool Enhancement
Learn more about recent enhancements to our Referral and Authorization web tool
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Communications on Wellness Visits and Colorectal Cancer Screenings
Humana is reaching out to Medicare members to remind them to contact their primary care physician (PCP) to make an appointment for a wellness visit.
