The Humana Oncology Quality Management Program, founded on evidence-based care standards, utilizes a counseling model within traditional preauthorization management for 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:
- New Hampshire
- New Jersey
- New York
- Rhode Island
- Texas (non-US Oncology practices) (please see below for special instructions)
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 does not review preauthorization requests from health care providers who participate in an independent practice association (IPA) or other risk network with delegated services; these health care providers need to refer to their IPA or risk network for guidance on processing preauthorization requests.
Submitting preauthorization requests
Choose from the following options to submit a request for authorization:
- Initiate a preauthorization request for an affected drug via the web by logging on to Oncology Analytics' website at , opens new window (participating cancer-care physicians only). Please note: Physicians must call 1-888-916-2616 to obtain a username and password.
- Fax a completed protocol request form to Oncology Analytics at 1-800-264-6128. Please use a secure cover sheet when sending a fax. , PDF opens new window
- Physicians and other clinicians in Texas may use the , PDF opens new window to submit preauthorization requests for their Humana-covered patients. You may wish to review , PDF opens new window for the form. Once complete, please fax it to Oncology Analytics at 1-800-264-6128. Include supporting clinical documentation (e.g., medical records, progress notes, lab reports, radiology studies, etc.) with your fax form.
Questions about this program may be made via telephone at 1 888-916-2616 (available Monday – Friday, 8:30 a.m. – 6 p.m., Eastern time). Physicians may also contact an Oncology Analytics medical director at this number. Outside of the stated hours, an on-call medical director will be paged.
Preauthorization and notification lists
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.
Consult Online tutorial
Learn how to request, schedule and follow up on imaging services and treatment plans for your Humana-insured patients online with Consult Online by reviewing this tutorial.