The Humana Oncology Quality Management Program, founded on evidence-based care standards, uses a counseling model for the preservice consultation management of chemotherapeutic drugs, symptom-management drugs and supporting agents.

This program is administered by Oncology Analytics for Humana commercial, Medicare Advantage (MA) and some administrative-services-only members in the following states:

  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Maine
  • Maryland
  • Massachusetts
  • New Hampshire
  • New Jersey
  • New York
  • Pennsylvania
  • Rhode Island
  • Texas (non-US Oncology practices) (please see below for special instructions)
  • Vermont

The terms prior authorization, precertification, preadmission and preauthorization are all used to refer to the preauthorization process. 

For MA private fee-for-service (PFFS) members and for services provided by nonparticipating health care providers for MA preferred provider organization members, preauthorization is not required. Notification is requested for these plans, but not required, as this helps coordinate care for our members.

Oncology Analytics (OA) reviews preauthorization requests from healthcare providers who participate in an independent practice association (IPA) or other risk network with delegated services; however, their review is provided to the risk provider in order to expedite their internal referral or authorization process.

Submitting preauthorization requests

Choose from the following options to submit a request for authorization:

  1. Initiate a preauthorization request for an affected drug via the web by logging on to Oncology Analytics' website at www.oncologyanalytics.com , opens new window (participating cancer-care physicians only). Please note: Physicians must call 888-916-2616 to obtain a username and password.
  2. Fax a completed protocol request form to Oncology Analytics at 800-264-6128. Please use a secure cover sheet when sending a fax. Protocol request form , PDF opens new window

State-specific preauthorization request forms

If you choose to fax, you can find state-specific forms in the Important Links box at top right on this page.

Oncology Analytics fax: 800-264-6128.

Questions

For answers to questions about this program, call 888-916-2616, Monday – Friday, 8:30 a.m. – 6 p.m., Eastern time. Physicians also can contact an Oncology Analytics medical director at this number. Outside of the stated hours, an on-call medical director will be paged.

View documents that list services and medications for which preauthorization may be required for patients with Humana Medicaid, Medicare Advantage, dual Medicare-Medicaid and commercial coverage.