Behavioral health services
Preauthorization and medical necessity reviews for Humana commercial and Medicare Advantage (MA) members' mental health and substance abuse inpatient, partial hospitalization, residential treatment and intensive outpatient services are managed by Humana Behavioral Health, a wholly owned Humana subsidiary.
Administrative services only (ASO) clients must purchase a behavioral health services product, such as managed behavioral health or integrated medical and behavioral health, in order to conduct preauthorization and medical necessity review of services. For ASO clients with outsourced behavioral health management or those that have purchased a network access only product, no utilization or case management services are provided by Humana or its clinical affiliates.
Please refer to the member's ID card for appropriate routing of claims or preauthorization inquiries regarding behavioral health services.