Interactive voice response (IVR) system capabilities

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

Call the number on the back of the patient’s Humana identification card to reach the IVR system.

Information available through IVR system

You can obtain a variety of information by using the IVR system.

The system can:

  • Confirm member coverage and the date the coverage began
  • Notify you if referrals are required by the member’s plan
  • Give you the status of a referral request
  • Provide the member’s deductible, copayment and coinsurance information
  • Provide the member’s out-of-pocket and lifetime maximum information
  • Retrieve claim status for specific members
  • Retrieve claim status for all your claims on one or more days
  • Initiate inpatient admission and non-HMO (health maintenance organization) outpatient preauthorization requests
  • Provide preauthorization request status, directing your call to a Humana customer care representative, if needed*

In addition, you can use the system to request that the following information be sent to you by fax:

  • Member eligibility information
  • Claims status: 40 claims per page, organized in a remit format

*Available in most areas

The IVR system gives you the option of requesting help from a Humana customer care representative. Assistance is available Monday through Friday on the following topics:

  • Medical eligibility, benefits and claims status: 8 a.m. to 8 p.m. Eastern time
  • Dental eligibility, benefits and claims status: 8 a.m. to 8 p.m. Eastern time
  • Preauthorizations: 8 a.m. to 6 p.m. Eastern time
  • Financial recovery: 8 a.m. to 5 p.m. Eastern time

Information you will need to use IVR

Before calling the IVR system, make sure you have the following information handy:

  • Nine-digit tax ID number or national provider identifier (NPI)
  • Nine-digit member ID number (listed on member's ID card)
  • Patient’s date of birth (mm/dd/yy)
  • Date of service in mm/dd/yyyy format (for specific options, such as claims or precertifications)
  • Your fax number (if a fax-back option is requested)
  • Specific information to initiate a preauthorization, including the following: CPT-4 (five-digit) codes for procedures and surgeries; ICD-10 codes for diagnoses; CPT or HCPCS codes for outpatient procedures

For more information, view our frequently asked questions, opens new window about preauthorization using the IVR system.