Preauthorization for facility-based sleep studies
Preauthorization is required for:
- Commercial fully insured plans
- Medicare Advantage health maintenance organization (HMO) and preferred provider organization (PPO) plans
- Dual-eligible Medicare/Medicaid Special Needs Plans
- Administrative services only members whose groups elect to utilize Humana's standard preauthorization process
The following groups are excluded from the preauthorization requirement but may give notification if they wish to:
- Medicare Advantage private-fee-for-service plans
- Medicare Advantage HMO risk groups
- Medicare Advantage Prescription Drug Plans
- Medicaid members
- Puerto Rico members
Health care providers can request preauthorization or provide notification for facility-based sleep testing by contacting the CIT via one of the following methods:
- Log into the provider self-service center available at Humana.com/providers (registration required); select “Referral & Authorization Submission.”
- Log into Availity.com (select markets only; registration required); select “Auths and Referrals” from the left navigation menu. Choose “Auth/Referral Inquiry” from the left menu to submit a request.
- Call Humana's interactive voice response line at 1-800-523-0023: This line is open 24 hours a day for automated precertification requests. Customer service representatives are available to assist you with requests from 8 a.m. to 8 p.m. EST, Monday through Friday (excluding major holidays). Press “0” on your keypad or say “operator” to be connected to a representative. Please have your tax ID number handy when calling.
Preauthorization requirements for administrative-services-only groups vary; please call to determine whether preauthorization is required. Home sleep studies do not require preauthorization.
Questions about submitting a preauthorization request for facility-based sleep studies may be directed to
Humana at 1-800-523-0023. Customer services representative are available to assist you with requests from
8 a.m. to 8 p.m. EST, Monday through Friday. Press “0” on your keypad or say “operator” to be connected to a
representative. Please have your tax ID number handy when calling.