The Genetic Guidance Program is a utilization management initiative designed to share information with physicians and members about the use and appropriateness of MD/GT. Board-certified genetic counselors are available to discuss genetic testing services, and preauthorizations. To initiate a request, you may call 1-800-523-0023. Representatives are available from 8 a.m. to 8 p.m. Eastern time, Monday through Friday.
Physicians and local labs (Puerto Rico only) have several options when submitting their preauthorization requests:
Physicians may log into Humana's secure provider portal at Humana.com/providers to initiate a preauthorization request.
Providers who are registered with Availity, may initiate preauthorization requests through Availity and the requests will be directed to our genetic counselors.
Physicians may initiate preauthorization request by calling Humana's Interactive Voice Response system (IVR) at 1-800-523-0023. If needed, representatives are available from 8 a.m. to 8 p.m. Eastern time, Monday through Friday. A board-certified genetic counselor may ask the physician questions about the patient's condition and past medical/family history. Genetic counselors can also answer questions related to the test(s) the physician is ordering and applicable Humana clinical policies. Requestor will receive notification of the outcome of the request.
Physicians/local labs may also request preauthorization via fax. To do so, download the preauthorization request form below, fill it out in its entirety and fax it to us at 1-855-227-0677. A board-certified genetic counselor will review the request and contact the physician/local lab if additional information is required. Approvals of requests are returned via phone or fax; non-approvals are sent via mail.
United States Request Form(265 KB) Download PDF English
Puerto Rico Request Form(556 KB) Download PDF English here. Once complete, please fax it to Humana at 1-800-266-3022. Include supporting clinical documentation (e.g., medical records, progress notes, lab reports, radiology studies, etc.) with your fax form.
Physicians and other clinicians in Indiana may use this form to submit authorization requests for their Humana-covered patients. Instructions are included on the form. Once complete, please fax it to Humana at 1-800-266-3022. Include supporting clinical documentation (e.g., medical records, progress notes, lab reports, radiology studies, etc.) with your fax form.
The physician should have relevant clinical information available in the patient's chart when requesting preauthorization, including:
While most genetic tests and molecular diagnostics require prior authorization, the following categories are excluded:
For all other tests, the health care provider should contact Humana to request preauthorization.