Electronic funds transfer and electronic remittance advice

Get paid faster and reduce administrative paperwork with electronic funds transfer (EFT) and electronic remittance advice (ERA). To start or update ERA and EFT, please sign in to the Availity.com portal. Enter the Humana Dental Payer Space and access the ERA/EFT Enrollment application. This functionality is no longer available on the Humana.com portal and has been fully migrated to Availity.

To access Electronic Remittance Advices

You can access your electronic remittance advices (ERAs) from the Humana.com dental provider portal by accessing the Dental Providers menu and selecting View Provider Payments under the “Payments” menu.

You can also access this information on the Availity portal. Select the Claims & Payments menu and choose Remittance Viewer. You will then see Remittance Inquiry (Humana) under Additional Remittance Tools.

Claims submissions

Claims mailing addresses

HumanaDental claims office
P.O. Box 14611
Lexington, KY 40512-4611

CompBenefits claims office
P.O. Box 14283
Lexington, KY 40512-4283

Electronic payer IDs
HumanaDental ID: 73288
CompBenefits payer ID: CX021

Support for dentists – Helpful tips regarding member benefits and claims

Accessing and interpreting payments for Humana Dental and CompBenefits patients, PDF

Learn about how to confirm Humana members’ benefits, how to submit claims or requests for pre-treatment estimates, and information about the Evidence of Remittance (EOR).

How to access and interpret information provided on remittances , PDF

Watch a video for helpful tips regarding member benefits and claims

Medicare dental benefits

Are you part of the HumanaDental Medicare network or the Humana Florida GoldPlus Dental network (for patients who purchased their plan in Florida)? If so, please visit Humana Medicare Advantage Supplemental Dental Benefits Information to find the most recent dental office handbook, Humana Medicare Advantage dental benefit descriptions and member-specific dental plans.

Medicare basic benefit exceptions for inextricably linked dental procedures

Inextricably linked dental services require an integrated and coordinated level of care to ensure the dental services are an integral part of the Medicare covered primary procedure or service. Please visit the Medicare Basic Dental Benefit Exception Guidelines, PDF to determine which dental procedures may be covered as part of a patient’s basic Medicare benefit when linked to the success of a covered medical procedure, as well as requirements to ensure efficient claims processing.

Medicare Advantage Member ID workaround

When submitting an Eligibility and Benefits inquiry on Availty.com you would normally enter the MA Member ID into the Patient ID field, and the member’s dental ID would display in the results. At this time you may see an error stating Availity was unable to reach the payer. While we are working diligently to correct this error, the below workaround is an alternate way to retrieve the member ID until the error is corrected.

  • In the Humana Dental payer space, access the View Member ID Card application and put in the Medicare Advantage ID number from the card.
  • This will return the dental ID number which can then be used in the Eligibility and Benefits inquiry and will return results with no issue.

Florida GoldPlus Dental Network name discrepancy

The name of the 2023 Humana Medicare Advantage dental network in Florida is the Florida GoldPlus Dental Network. However in Availity, this is still showing the outdated 2022 network name CAREington Medicare. We are working to identify an appropriate solution but this will take significant time to correct.

  • HumanaDental Medicare network is the nationwide network for MA members who bought their MA plan outside of Florida
  • 2023: Florida GoldPlus Dental is a nationwide network for MA members who bought their plan in Florida (Florida plans in 2022 used the CAREington Medicare network).

Watch a video to see how it works

DHMO and Advantage network plan summaries

Are you part of the dental health maintenance organization (DHMO) or Advantage network? If so, you may want to review these plan summaries.

DHMO and Advantage network plan summaries, PDF

Federal Dental Plan Documents

If you treat patients with the Federal Dental Plan, you can review these exclusive provider organization (EPO) and preferred provider organization (PPO) plan summaries and helpful documents

EPO 2024 copay table, PDF

EPO 2023 copay table, PDF

PPO schedule of benefits, PDF

First payer guidelines, PDF

Federal FAQs, PDF

HumanaDental issues digital member ID cards

Patients covered by a Humana Dental commercial group plan have the convenience of a digital member ID card and may no longer need to present a physical member ID card. They can use Humana tools to print a paper version of their card or email or fax a copy to your office. They also may present a digital ID card using their MyHumana mobile app. We ask that you accept a digital, fax or printed version of these patients’ ID cards.

For more information, refer to these frequently asked questions and answers.

HumanaDental digital member ID cards FAQs, PDF

Member summary information

The Humana Member Summary is a tool that displays patient-specific, clinically relevant information in a standardized format to help you identify opportunities to improve clinical outcomes and reduce medically related costs.

Dental providers can follow these steps to access the Humana Member Summary, PDF.

Mandatory Medicare compliance requirements

The Humana Dental Medicare network provides benefits to Humana members enrolled in Medicare Advantage and prescription drug plan programs. The Centers for Medicare & Medicaid Services mandates that all Humana-contracted entities, including those contracted with Humana subsidiaries, complete compliance requirements each year.

Mandatory Medicare compliance requirements, PDF

Third-party network access

Updated September 2023—Humana enters into agreements that grant some third parties access to Humana’s contracted provider network. The provider agreement that dental providers enter into with Humana allows Humana to provide such third parties with access to Humana’s contracted provider network and in turn Humana’s contracted dental provider’s services. If a contracted dental provider no longer wants to have third parties accessing its services under the contract the dental provider and Humana entered into, the contracted dental provider can reach out to its Humana dental representative to be removed from third-party access. Third parties with access to Humana’s contracted provider network:

  • Florida Combined Life (FCL)
  • Group & Pension Administrators (GPA)
  • Insurance Management Services (IMS)
  • New Benefits (NB)
  • TeamCare, a Central States Health Plan

Forms

W9

Some Humana networks may have additional participation criteria physicians and other healthcare providers must meet to be granted participation status. If you are eligible to use our online application, please review this important information.

Form W-9 (Rev. October 2018), PDF