You can obtain a variety of information by using the IVR system.
The system can:
- Confirm member coverage and the date the coverage began.
- Notify you if referrals are required by the member’s plan.
- Give you the status of a referral request.
- Provide the member’s deductible, copayment and coinsurance information.
- Provide the member’s out-of-pocket and lifetime maximum information.
- Retrieve claim status for specific members.
- Retrieve claim status for all your claims on one or more days.
- Initiate inpatient admission and non-HMO (health maintenance organization) outpatient preauthorization requests.
- Provide preauthorization request status*, directing your call to a Humana customer care representative, if needed.
In addition, you can use the system to request that the following information be sent to you by fax:
- Member eligibility information.
- Claims status: 40 claims per page, organized in a remit format.
- Referral documentation.
- Preauthorization documentation.
*Available in most areas
The IVR system gives you the option of requesting help from a Humana customer care representative. Assistance is available Monday through Friday on the following topics:
- Medical eligibility, benefits and claims status: 8 a.m. to 8 p.m. EST.
- Dental eligibility, benefits and claims status: 8 a.m. to 8 p.m. EST.
- Preauthorizations: 8 a.m. to 6 p.m. EST.
- Financial recovery: 8 a.m. to 5 p.m. EST.