Humana is publishing its medical claims payment policies online as a new avenue of transparency for health care providers and their billing offices. This information about reimbursement methodologies and acceptable billing practices may help health care providers bill claims more accurately to reduce delays in processing claims, as well as avoid rebilling and additional requests for information.
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Medical claims payment policy disclaimer
The intended audience of these medical claims payment policies is healthcare providers who treat Humana members. These policies are made available to provide information on certain Humana claims payment processes. These policies are guidelines only and do not constitute a benefit determination, medical advice, guarantee of payment, plan preauthorization, an Explanation of Benefits or a contract. These policies are not intended to address every claim situation. Whether a procedure is covered shall be determined based on the terms and provisions of a specific member plan or policy. Claims may be affected by other factors, such as state and federal laws and regulations, provider contract terms and our professional judgment. These policies are subject to change or termination by Humana. Humana has full and final discretionary authority for their interpretation and application.