The links below provide information on how you can express your interest in participating with Humana and the credentialing process.
Use these links to access provider education information and resources.
Access Humana claim information for healthcare providers.
Learn about preauthorization and notification processes and download available lists.
Discover and download information on the newest tools and resources available to providers by perusing the following documents.
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.
Medicare Advantage Member and Primary Physician Relationship Promoted
The 2013 plan year has Humana continuing its efforts to connect Medicare Advantage PPO and PFFS members to primary physicians.
Prepare Now for Transition to ICD-10
Learn more about Humana's readiness plan and find answers to your frequently asked questions for ICD-10.
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.
Flu Vaccine Guidance
For the 2012-2013 flu season, the Centers for Disease Control and Prevention urges everyone 6 months and older to get an annual flu vaccine.
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.
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.
Potential Drug-to-Drug Interactions
Health care providers may soon notice an increase in communications from Humana regarding potentially problematic combinations of medications.
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.
Claims Submission Time Frames
Health care providers are encouraged to take note of these claims submission time frames for Medicare Advantage and commercial claims
Humana Medicare Rewards
Access information for physicians regarding the 2012 Humana Medicare Rewards Program
Humana Claims Information Only a Click or Call Away
Find information about how to accurately code and document diagnoses and services provided to Humana members.
Important Information About Sequestration Reductions
Find out how sequestration reductions are affecting health care providers’ payments.
Humana Introduces Member Summary Tool
A new tool that gives physicians a high-level overview of a patient’s key quality-related metrics and medically relevant information in a consolidated format.
2013 Medicare formulary changes
See a list of commonly used medications that will be impacted by Humana Medicare formulary changes in 2013.
High-risk Medication Formulary Changes
Effective Jan. 1, 2013, certain drugs under the Humana Medicare formularies will have new limitations or will require utilization management for the 2013 plan year.
2013 commercial formulary changes
See a list of some commonly used medications that will be impacted by Humana commercial formulary changes in 2013.
Inpatient-only Procedure Information for Medicare Members
Learn more about procedures that should be performed on an inpatient basis for the Medicare population
Humana Clarifies Noncovered Services Enforcement for Facilities
Providers to be notified of Well Dine meal requests
Best Doctors® Comes to Wisconsin-based Members
Best Doctors® Comes to Wisconsin-based Business Health Care Group (BHCG) Members
New Professional and Facility Claim Code Edits Coming
Find out more about updates to Humana’s professional and facility claims payment systems
New Professional and Facility Claim Code Edits Effective April 13, 2013
Find out more about updates to Humana’s professional and facility claims payment systems effective April 13, 2013
Benefit Estimator Tool Now Available
View information on select topics related to health reform.
This quarterly publication provides updates on news and tools to make it easier for you to do business with Humana.
Humana is getting the word out about how to prevent fraud, waste and abuse.
Fraud, Waste and Abuse
2011 Federal Employee Health Benefit (FEHB) Tobacco Cessation Program
View a list of modifications to Humana's claims payment policies.
Humana is dedicated to supporting providers’ administrative needs.
Humana provides a range of guidance to help providers understand how our pharmacy benefits work, so doctors and patients can work together to get the most value from prescription drug benefits.
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