Authorization and Referral Tool

Humana’s electronic referral and authorization tool provides a fast and effective way to submit inpatient and outpatient referrals and authorization requests. This tool is accessible to registered users of Humana.com.

Authorizations / Referrals

Outpatient Echocardiography/Coronary Angioplasty/Stent 
Outpatient transthoracic echocardiogram (TTE) and outpatient coronary angioplasty/stent procedures are administered by HealthHelp.

Preauthorization and Notification Lists 
View and Download Lists

Molecular Diagnostic/ Genetic Testing
Preauthorization is required for services related to molecular diagnostic/genetic testing (MD/GT)

Radiation Therapy
HealthHelp administers preauthorization for radiation therapy

Pain Management
OrthoNet administers preauthorization for pain management services

Outpatient Therapy
OrthoNet administers preauthorization for outpatient therapy, speech therapy, occupational therapy and physical therapy

Radiology Services 
Use RadConsult™ to preauthorize or submit notification for radiology services.

Authorization and Referral Tool
Learn about the features of the authorization and referral tool.

Cardiac Catheterization 
Use RadConsult™ to preauthorize or submit notification for cardiac catheterizaion.

Chemotherapy – Oncology Analytics (Broward County, Dade County, Palm Beach County and Tampa)
To request preauthorization of chemotherapy for members in this area.

Chemotherapy – New Century Health (Chicago, IL; Cincinnati, OH; Kentucky; and Milwaukee, WI) 
To request preauthorization of chemotherapy for members in this area.

Cardiac Devices 
HealthHelp administers preauthorization for cardiac implantable devices (e.g., pacemakers, defibrillators and cardiac resynchronization therapy) and wearable defibrillators (e.g., LifeVest®).

Facility-Based Sleep Studies (PSG)
Humana’s Clinical Intake Team (CIT) administers preauthorization for facility-based sleep studies, also known as polysomnography (PSG).

Information for providers on medical and pharmacy coverage for new procedures, devices, medications

Medical and Pharmacy Coverage Policies

Learn more about Humana's Medical and Pharmacy Coverage Policies

Medical and Pharmacy Coverage Policies (link opens in new window) 

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