Negative pressure wound therapy

Preauthorization of negative pressure wound therapy (NPWT) is required for all Humana members except the following:

  • Members treated by Chicago risk and delegated providers.
  • Florida Medicare Advantage (MA) health maintenance organization (HMO) and Medicaid HMO members.
  • Health Care Partners commercial and MA HMO members.
  • Puerto Rico commercial and MA members.

The terms prior authorization, precertification, preadmission, preauthorization and notification are all used to refer to the preauthorization process. For MA private fee-for-service (PFFS) plans, notification is requested, not required.

Submitting preauthorization requests

Initial therapy: If you want to preauthorize initial NPWT, please complete this form.

Initiation of NPWT form (215 KB)

Continuing therapy: If you want to request continued coverage of NPWT, please complete our reauthorization form.

NPWT reauthorization form (166 KB)

Instructions for submitting the initiation and authorization forms are found on the last page of each form.

Texas authorization request form (145 KB)

Physicians and other clinicians in Texas may use this form to submit authorization requests for their Humana-covered patients. Instructions are available 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.

Indiana authorization request form (761 KB)

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.

Questions

Questions about the preauthorization or reauthorization of NPWT may be directed to Humana’s clinical intake team at 1-800-523-0023. Representatives are available Monday through Friday from 8 a.m. to 8 p.m. Eastern time.