Medicare members' EOBs include encounter information
Part C EOBs
Humana's Medicare Part C explanations of benefits (EOBs) now include information about all claims, including encounters and claims processed by delegates.
Humana to require prior authorization for Diovan in April
Get details on a change affecting Medicare formularies.
2015 Medicare Sustainable Growth Rate (SGR) Up for Debate
2015 SGR Update
Find out how discussions regarding the Medicare Sustainable Growth Rate (SGR) formula may affect health care providers.
New Professional and Facility Claim Code Edits for 2015
Code-edit Update Schedule
Find out more about updates to Humana’s professional and facility claims payment systems.
Negative pressure wound therapy (NPWT) supplier changes
Learn about a new national supplier for NPWT products and services
Changes to 2015 Formularies Announced
2015 formulary changes
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.
Pharmacy Prior Authorization Requests Available Online
Learn more about a new pharmacy electronic prior authorization (PA) tool to quickly submit PA requests online.
New Training Demos for Provider Self-service Tools Now Available
Learn about our self-service tools with self-guided training modules.
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.
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.
Compliance Requirements for Health Care Providers and CMS Mandates Humana-contracted entities to complete compliance requirements
Medicare compliance requirements
Compliance Requirements for Healthcare Providers
The Centers for Medicare & Medicaid Services (CMS) mandates that all Humana-contracted entities, including those contracted with Humana subsidiaries, complete compliance requirements.