Two ways to submit your claims

  • Electronic claims submission
  • Paper claims submission

Valid National Provider Identifiers (NPIs) are required on all electronic claims and strongly encouraged on paper claims. If a paper claim does not have all necessary NPIs, it may be denied or be subject to delays in adjudication.

Electronic claims submission Paper claim submission

Submitting claims electronically

Healthcare professionals and facilities can use the Availity Provider Portal and electronic data interchange (EDI) services as no-cost solutions for submitting claims electronically. To register for the Availity portal or learn more about Availity claims solutions, visit Availity.com., opens new window

Waystar, a ZirMed and Navicure company, offers healthcare providers no-cost solutions for electronic claims submission. In addition, Waystar’s auto-adjudication tool checks claims for accuracy more quickly than a manual review. To get started, visit ZirMed.com., opens new window

Healthcare providers also may file claims by EDI through the clearinghouse of their choice. Some clearinghouses and vendors charge a service fee. Contact the clearinghouse for information.

When submitting claims to a clearinghouse, you may use the following payer IDs for Humana:

  • Claims: 61101
  • Encounters: 61102

Advanced claims editing

All EDI submissions to Humana pass through Availity. A process known as Advanced Claims Editing (ACE) applies certain coding rules to batch medical claims submitted through the Availity gateway via EDI before they enter Humana’s system. This allows claims submitters to identify potential coding issues up front and reduce processing delays that can result from incomplete or inaccurate claims data.

For more information, review Electronic batch claims experience streamlined: Advanced claims editing (ACE)., PDF opens new window

Time frames for claim submission

Please note the following time frames for submitting Medicare Advantage and commercial claims:

Medicare Advantage: Claims must be submitted within 1 calendar year from the date of service.

Commercial: Claims must be submitted within the time stipulated in the provider agreement or the applicable state law. Generally, these claims must be submitted within:

  • 180 days from the date of service for physicians
  • 90 days from the date of service for facilities and ancillary providers

When a claim is submitted in error to a carrier or agency other than Humana, the timely filing period begins as of the date the provider was notified of the error by the other carrier or agency.

Checking claim status online

Healthcare professionals can check the status of submitted claims on the Availity provider portal. Registration is required for access to the portal; go to Availity.com , opens new window

To find out more, please review this flyer., PDF opens new window

Assistance with claim submission

If your claim rejects at the vendor level, please contact your vendor for assistance.

If you need further assistance with electronic claims submission, please call your vendor's customer service help line.

Texas deficient claims

If you’re a Texas-based physician or other healthcare provider, read this flyer to learn how to check your deficient claims online.

View deficient claims, PDF opens new window

To decrease administrative costs and improve cash flow, clinicians and facilities are encouraged to use electronic claims submission whenever possible.

When it is necessary to submit paper claims, you can use the addresses below. Please keep in mind, however, that the claim or encounter mailing address on the member’s identification card is always the most appropriate to use.

Valid National Provider Identifiers (NPIs) are required on all electronic claims and strongly encouraged on paper claims. If a paper claim does not have all necessary NPIs, it may be denied or be subject to delays in adjudication.

Paper claims and encounters submission addresses

Humana medical claims:

Humana Claims
P.O. Box 14601
Lexington, KY 40512-4601

HumanaDental® claims:

HumanaDental Claims
P.O. Box 14611
Lexington, KY 40512-4611

Humana encounters:

Humana Encounters
P.O. Box 14605
Lexington, KY 40512-4605

Claim overpayments:

Humana
P.O. Box 931655
Atlanta, GA 31193-1655

HumanaOne® claim submissions:

HumanaOne
P.O. Box 14635
Lexington, KY 40512-4635

Claims submission time frames

Health care providers are encouraged to take note of the following claims submission time frames:

Medicare Advantage: Claims must be submitted within one calendar year from the date of service or as stipulated in the provider agreement.

Commercial: Claims must be submitted within the time stipulated in the provider agreement or the applicable state law. Generally, these claims must be submitted within:

180 days from the date of service for physicians

90 days from the date of service for facilities and ancillary providers

When a claim is submitted in error to a carrier or agency other than Humana, the timely filing period begins as of the date the provider was notified of the error by the other carrier or agency.

Billing guidelines for roster bills submitted on paper claims

Physicians and other health care providers should follow the billing guidelines below when submitting roster bills to Humana:

  • Physicians and health care providers may submit multiple documents in a single large envelope.
  • Documents may include information regarding multiple patients.
  • Physicians and health care providers may submit CMS 1500 forms or UB04 forms with an attachment listing multiple patients receiving the same service. The claim form should have the words "see attachment" in the "Member ID" box.

Please send roster bills to the following address:

Humana
Attn: Claims
P.O. Box 14601
Lexington, KY 40512-4601

Texas deficient claims

If you’re a Texas-based physician or other healthcare provider, read this flyer to learn how to check your deficient claims online.

View deficient claims, PDF opens new window

Checking claim status online

Healthcare professionals can check the status of submitted claims on the Availity Provider Portal