Submitting preauthorization requests
Preauthorization is required for all commercial and most Medicare members. Puerto Rico members are exempt from the requirement. For Medicare Advantage (MA) Private Fee-for-Service (PFFS) plans, notification is requested, not required. For administrative-services-only (ASO) groups, authorization is not required; but, if it is requested, HealthHelp will manage services.
Exclusions from the preauthorization requirement include the following:
- Puerto Rico commercial and MA members
- Florida MA HMO and Medicaid HMO members
- Ochsner commercial and MA HMO members
- Health Care Partners commercial and MA HMO members
- Chicago risk and delegated providers
Submit a request by phone
Available 7 a.m. to 7 p.m. CST, Monday through Friday, and 9 a.m. to 4 p.m., Saturday.
Submit a request online
Health care providers may submit an online request via HealthHelp’s RadConsult online program.
Questions about prior authorization for cardiac devices may be directed to RadConsult program support at 1-800-546-7092. Assistance is available Monday through Friday from 7 a.m. to 7 p.m. and Saturday from 9 a.m. to 4 p.m. CST.
Humana Cardiology Benefit Management
Learn more about this program and the patient information required when requesting preauthorization or providing notification.