Provider claim resources

Humana supports health care providers' administrative needs with resources for Health Insurance Portability and Accountability Act (HIPAA) compliance, electronic claim submission, claim edits and guidelines and more.

Managing health benefits

Claims and encounter submission made easier

Find resources for electronic submission.

Electronic claims and encounters

Submitting paper claims and encounters

View addresses to use when submitting paper claims to Humana.

Claim and encounter addresses

ICD-10

Find training tips and answers to frequently asked questions about ICD-10.

ICD-10 information

Health care reform

Learn about HIPAA-related changes affecting claims that are submitted electronically.

Reform details

Humana claim coding guidelines

Download coding guidelines related to specific diseases.

Claim coding guidelines

Claims payment policies

In an effort to provide more transparency for healthcare providers and their billing offices, Humana publishes its medical claims payment policies online.

View claims payment policies

Claims processing updates

View a schedule of changes planned for our claims payment systems.

Claim processing edits

Preauthorization and notification lists

Download comprehensive lists of services requiring preauthorization.

Preauthorization and notification lists

Improve Your Management of Payments

Learn about real-time claim adjudication and processing transactions with the Humana Access Visa Credit Card.

Payments

Interactive voice response system

Check claim and referral status, initiate prior authorizations and perform other transactions.

IVR

Provider payment integrity policies

View policies for post-payment audits, technical denials and more.

Provider payment integrity policies

Texas deficiency tool

If you’re a Texas-based provider, watch this brief presentation to learn how to check your deficient claims online.

Watch presentation

Addressing fraud, waste and abuse

Learn how to detect and prevent fraud, waste and abuse with free training materials, tools and resources from Humana.

Learn more about Humana’s commitment

Humana’s YourPractice

This bimonthly publication provides updates that make it easier for you to do business with Humana.

View the current issue. (link opens in new window)