Detailed Humana Claims Information Only a Click or Call Away

Health care providers with busy schedules can simplify their claims inquiries by using the Web tools available on Humana.com/providers (registration required) or Availity.com (select markets only, registration required), or by calling Humana’s interactive voice response (IVR).

Online Tools

Using the Claim Search/Claim Reconciliation tool on Humana.com/providers (registration required), health care providers can locate claims associated with their tax identification number (TIN). They can search by:

  • Service date
  • Claim number
  • Member, by service date
  • Family unit, by service date
  • Date processed
Once a claim is located, information displayed includes:
  • Patient name
  • Heath care provider’s patient account number
  • Claim number
  • Check number
  • Check date
  • Payment method
  • Each line item includes the following details:
    • Dates of service
    • Current Procedural Terminology (CPT®)/Healthcare Common Procedure Coding System (HCPCS)/revenue codes
    • Quantity
    • Billed amount/paid amount/copayment amount/deductible amount/discount amount

If a health care provider finds that additional clarification or information is needed to process a claim, Humana has additional tools to help – Electronic Claim Correction and Electronic Claim Attachment. Find step-by-step instructions here.

Telephone Resources

Another option to check the status of a claim is to access Humana’s IVR claims tool. Like Humana’s Web portal, it is an easy and efficient method to check a claim status.

A health care provider may call Humana’s customer service at 1-800-4HUMANA (1-800-448-6262) to access information on claims 24 hours a day, seven days a week. The IVR system allows health care providers to check the status on multiple claims for one member or claims for multiple members all on one call, which can save time.

When a health care provider uses the IVR claims tool, he or she will need the following information:

  • Health care provider identification number
  • Member identification number (listed on member’s identification card)
  • Member's date of birth
  • Date of service
  • Fax number (if a fax-back option is requested)

After providing an identification number, the health care provider can follow the voice prompts to select the claims option.

After choosing the claims option, he or she will be able to choose to:

  • Listen to claims information
  • Have claims information faxed
  • Have claims information mailed

The claims tool can be used to check claims status by member or by a date of service. It can offer a basic summary of the claims requested or give additional information about the claim. The IVR tool can provide a claim amount and whether the claim was paid (and give the amount), denied or adjusted. It can even give the check number on a paid claim.

For more information, contact a Humana Web Specialist at 1-877-845-3480 or email deployment@humana.com.