Claims and payments

The pages below lead to authorization and referral information, electronic claims submission, claims edits, educational presentations and more.

A doctor writes on a chart.

Claims and payments

Preauthorizations and referrals

Get details on how to request preauthorization for various tests and procedures, view online submission options and access state-specific forms.

Claims and encounter submission

Learn about the options for submitting claims electronically, the time frames for claim submission, claim status checks and more.

Claims processing edits

View notifications of updates made to our claims payment systems and see notifications of upcoming changes.

Interactive voice response (IVR) system

The IVR system provides automated information on claims, benefits and more, 24 hours a day.

Claims coding

Download claim coding and payment inquiry process guidelines.

Claims payment policies

Learn about reimbursement methodologies and acceptable billing practices.

Reconsiderations and appeals

Access information about medical claim payment reconsiderations and member appeals for Humana participating and nonparticipating physicians, hospitals and other health care providers.

Electronic claims payments

Learn about the options Humana offers.

Payment resources

Learn about a benefit estimator tool and real-time claim adjudication.

Payment integrity and disputes

Find policies and procedures that help Humana ensure claims accuracy and handle payment discrepancies.

Claims Payment Inquiries

To simplify claim payment inquiries, Humana has worked to clarify its process and to ensure that you have the support you need.

Making it Easier

View a series of educational presentations about Humana’s claims payment policies and processes.