Humana’s benefit estimator is a secure web tool you can use to create a personalized estimate of a patient’s payment responsibility. The estimate is specific to the health care provider and treatment/service and based on a real-time snapshot of the patient’s benefits. This facilitates financial discussions between you and your patients so that payment arrangements can be made at the time of service.
To take advantage of this tool, you must be a registered user of the Availity Web Portal or Humana.com secure provider portal.
Locating this tool on the Availity Web Portal
On the Availity Web Portal, you can access the benefit estimator through the “Patient Cost Estimator” button:
Locating this tool on Humana.com
Please note that Humana is transitioning to the Availity Web Portal as the online site for health care providers to complete secure administrative tasks online. However, if you still have access to the Humana.com secure portal, you can access the benefit estimator tool as follows:
For more information about this or other web tools, please send an email to eBusiness@Humana.com.
Real-time adjudication (RTA) allows a health care provider to bill for service before the patient leaves the office and to receive a fully adjudicated response from the health plan at the time of service.
Humana can adjudicate claims in real time for some of its health plans. Members on these plans have been assigned unique member identifiers (UMIDs) that consist of nine digits followed by a two-digit suffix. The UMID for these members usually begins with zeros (example: 000123456-01). The UMID can be found on the member’s Humana identification card. Claims that are adjudicated in real time are still subject to post-adjudication review and corrections.
Humana has worked with a number of practice management systems and clearinghouses, including athenahealth Inc. and Availity, to offer RTA.
RTA can be advantageous to all parties involved in the health care industry, especially health care providers concerned about the potential for bad debt. However, several factors may impact your ability to implement RTA:
Humana’s eBusiness consultants can help you explore your options for using the benefit estimator or RTA. To learn more, please send an email to eBusiness@Humana.com.