Inpatient Behavioral Health: Inpatient behavioral health will require prior authorization. We will make a decision about your request within 24 hours.
If additional information is needed to make the decision, the review could take up to an additional 14 days. If this happens, Humana will send you a written notice along with information on how to file an appeal on the extension.
In most cases, if you are receiving a service and a new request is made to keep receiving a service, we must tell you at least 10 days before we change the service if we decide to reduce, stop or restrict the service. If we approve a service and you have started to receive that service, we will not reduce, stop or restrict the service during the approval period unless we determine the approval was based on information that was known to be false or wrong.
If we deny payment for a service, we will send a notice to you and your provider the day the payment is denied. These notices are not bills.