Preauthorization for radiology benefits is administered by HealthHelp, a nationally recognized specialty benefit management organization. Preauthorization is required for radiology services.
The terms prior authorization, precertification, preadmission, preauthorization and notification are all used to refer to the preauthorization process.
Exclusions from the preauthorization requirement include the following:
For Medicare Advantage Private Fee-for-Service (PFFS) plans, notification is requested, not required.
Humana requires that preauthorization for any radiology treatment plan ordered for a Humana-covered patient, including MA PFFS notification, be administered through HealthHelp’s online program, RadConsult. These treatment plans include computerized tomography (CT) scans, magnetic resonance angiograms (MRA), magnetic resonance imaging (MRI), nuclear stress tests, positron emission tomography (PET) scans and single-photon emission computerized tomography (SPECT) scans.
Submit a request by phone
Available 7 a.m. to 7 p.m., Monday through Friday and 9 a.m. to 4 p.m. CST, Saturday
Submit a request online
Health care providers may submit a request to RadConsult, HealthHelp's online program.
Humana Radiology Benefit Management
Learn more about this program and the patient information required when requesting preauthorization or providing notification.
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Learn how to request, schedule and follow up on imaging services and treatment plans for your Humana-insured patients online with RadConsult by reviewing this tutorial.
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If you have technical questions about the RadConsult preauthorization system, please contact RadConsult support staff at email@example.com or call 1-800-546-7092. Assistance is available Monday through Friday from 8 a.m. to 6 p.m. CST.
For clinical questions, call 1-866-825-1550. 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.