What's new

What's New

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

New options for electronic claims payment

Find out how collaborations with CAQH and J.P. Morgan Chase have created new payment choices for physicians, facilities and other health care providers.

Learn more

Humana Platform for Testing ICD-10 Readiness Available

Learn more about how practitioners can work with Humana to assess their ICD-10 readiness.

ICD-10 testing

Medicare members' EOBs include encounter information

Humana's Medicare Part C explanations of benefits (EOBs) now include information about all claims, including encounters and claims processed by delegates.

Part C EOBs

Humana to require prior authorization for Diovan in April

Get details on a change affecting Medicare formularies.

Diovan information

2015 Medicare Sustainable Growth Rate (SGR) Up for Debate

Find out how discussions regarding the Medicare Sustainable Growth Rate (SGR) formula may affect health care providers.

2015 SGR Update

New Professional and Facility Claim Code Edits for 2015

Find out more about updates to Humana’s professional and facility claims payment systems.

Code-edit Update Schedule

Negative pressure wound therapy (NPWT) supplier changes

Learn about a new national supplier for NPWT products and services

NPWT changes

Changes to 2015 Formularies Announced

Effective Jan. 1, 2015, certain drugs will have new limitations or will require utilization management under the Humana commercial and Medicare formularies for the 2015 plan year.

2015 formulary changes

Pharmacy Prior Authorization Requests Available Online

Learn more about a new pharmacy electronic prior authorization (PA) tool to quickly submit PA requests online.

e-PA Requests

New Training Demos for Provider Self-service Tools Now Available

Learn about our self-service tools with self-guided training modules.

Training demos

January 2015 updates to preauthorization and notification lists announced

Humana is updating its preauthorization and notification lists for all commercial fully insured plans, Medicaid plans, Medicare Advantage (MA) plans and dual Medicare-Medicaid plans, effective Jan. 26, 2015.

PAL updates

CMS Adjusts Hospice Medication Coverage for Medicare Members with Part D Plans

Medicare members enrolled in hospice care will need a prior authorization for medications covered under Medicare Part D if they are prescribed for diagnoses unrelated to the member’s terminal illness.

Hospice medication

Compliance Requirements for Health Care Providers and CMS Mandates Humana-contracted entities to complete compliance requirements

Medicare compliance requirements

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

Compliance Requirements for Healthcare Providers
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.

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