What's new

What's New

Read key updates for health care providers and their staff members.

Receive Immediate Preauthorization Determinations Online

Physicians are encouraged to use a new preauthorization submission tool on Availity.com.

Learn More about Nondiscrimination Notice Requirements

Some health care professionals may be required to post information about nondiscrimination and accessibility requirements.

Find Guidelines for Patient Transfer Requests

Learn more about guidelines for patient transfer requests from primary care physicians (PCPs), physician groups or independent practice associations (IPAs) acting on behalf of a PCP.

Updates Affect Payments for Medicare Members’ Basic Radiology Claims

Patients with Humana Medicare coverage need to pay a copayment for basic radiology services, when applicable.

Action Required to Maintain Access to Humana’s Secure Online Tools

As Humana phases out its secure online portal, physicians and other health care professionals will need to access online tools for working with Humana on the Availity Web Portal.

New Medicare Outpatient Observation Notice (MOON) requirement effective March 8, 2017

Effective March 8, 2017, hospitals and CAHs are responsible to provide the written MOON and a verbal explanation of the notice to all Original Medicare and MA beneficiaries who receive outpatient observation services for more than 24 hours.

Assistant Surgeon Reimbursement Updated

Humana’s reimbursement policy for a physician acting as an assistant surgeon has changed for Humana commercial plans.

Humana Policies Affect Health Care Professionals and Their Patients

Humana creates operating policies and procedures to help maintain a high level of service to its members and network physicians and other health care professionals.

Find Policies on Prior Authorization, Quantity Limits and Step Therapy

Humana strives to make the prescription process as easy as possible for physicians, health care professionals and their patients. Some prescriptions, however, require more attention than others.

Sign Up with Availity to Make Working with Humana Online Easier than Ever

Compliance Requirements for Health Care Providers

The Centers for Medicare & Medicaid Services (CMS) and Humana’s Medicaid contracts mandate that all Humana-contracted entities, including those contracted with Humana subsidiaries, complete compliance requirements.

Preauthorization and Notification Lists Updated for 2017

On Jan. 23, 2017, Humana will update preauthorization and notification lists for all commercial fully insured plans, Medicare Advantage (MA) plans, dual Medicare-Medicaid plans and Medicaid plans.

Simplifying Clinical Quality For Everyone

Humana has simplified our clinical quality measures to a more manageable number that impact patient health.

Find a Healthcare Provider

Access resources

View clinical guidelines, quality-related materials, drug utilization review information and more.

Clinical resources
Addressing fraud, waste and abuse

Addressing fraud, waste and abuse

Learn how to detect and prevent fraud, waste and abuse with free training materials, tools and resources from Humana.

Learn more about Humana’s commitment

Humana’s YourPractice

This bimonthly publication provides updates that make it easier for you to do business with Humana.

View the current issue.