Educational presentations

“Making It Easier for Physicians and Other Healthcare Providers” is a series of educational presentations about Humana’s claims payment policies and processes. Additional materials will be added periodically.

Tools and Resources for Physicians and Other Healthcare Providers

Updated: November 2019. Learn about Humana’s inventory of useful tools and resources, which can simplify your claims-related and other interactions with Humana. Printable resource guides are included. Runtime: 9:23

View video presentation here , Tools and Resources for Physicians and Other Healthcare Providers, opens new window

Modifiers 59 and X{EPSU}:

Updated: August 2020. Learn about Humana’s policy on the use of Modifier 59 and the X{EPSU} modifiers. This information applies for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. A printable tip sheet is included. Runtime: 13:20

View video presentation here , Modifiers 59 and X{EPSU}, opens new window

Application of Medicare NCD/LCD Guidelines

Updated: August 2020. Learn how Humana administers Medicare national coverage determinations (NCDs), local coverage determinations (LCDs) and related articles for Medicare Advantage plans. This presentation includes a printable tip sheet. Runtime: 12:10

View video presentation here , Application of Medicare NCD/LCD Guidelines, opens new window

Claim Disputes and Corrected Claims

Updated: August 2020. Learn about Humana’s processes for medical claim disputes and corrected claims. This information pertains to professional and facility claims submitted for your patients with Humana Medicare Advantage and commercial plans. This presentation includes a printable tip sheet. Runtime: 13:49

View video presentation here , Claim disputes and corrected claims, opens new window

Common Errors — Reporting Diagnosis Codes in the Primary Position

Updated: August 2020. Learn how to avoid some common errors when reporting primary diagnosis codes for claims submitted for your patients with Humana Medicare Advantage, commercial and Medicaid plans. This presentation includes a printable tip sheet. Runtime: 16:22

View video presentation here , Common Errors – Reporting Diagnosis Codes in the Primary Position, opens new window

Bilateral Services and Modifier 50

Updated: July 2020. Learn about Humana’s policies for reporting bilateral services and the use of modifier 50 for services provided to Medicare Advantage, commercial and select Medicaid members. This presentation includes a printable tip sheet. Runtime: 10:25

View video presentation here , Bilateral Services and Modifier 50, opens new window

Modifier 24

Updated: May 2020. Learn about Humana’s policy on the use of modifier 24 to indicate an unrelated evaluation and management (E/M) service by the same physician or other qualified healthcare professional during a postoperative period. This information applies to patients with Humana Medicare Advantage and commercial plans. A printable tip sheet is included. Runtime: 10:32

View video presentation here , Modifier 24, opens new window

Understanding an Explanation of Remittance (EOR)

Updated: May 2020. Understand your Humana EOR for your patients with Humana Medicare Advantage, commercial and Medicaid plans. This presentation includes a printable tip sheet. Runtime: 17:56

View video presentation here , Understanding an Explanation of Remittance (EOR), opens new window

Home Health Billing

Updated: May 2020. Learn about Humana’s guidelines for submitting claims for home health services for your patients with Medicare Advantage and commercial plans. This presentation includes a printable tip sheet. Runtime: 12:51

View video presentation here , Home Health Billing, opens new window

Chronic Care Management and Principal Care Management Services

Updated: April 2020. Learn about Humana’s policy for coverage of chronic care management, complex chronic care management and principal care management services when submitting claims for your patients with Humana Medicare Advantage and Medicaid plans. This presentation includes a printable tip sheet. Runtime: 14:48

View video presentation here , Chronic Care Management and Principal Care Management Services, opens new window

Drug Testing and Codes (2019-2020)

Updated: February 2020. Learn about Humana’s policies on drug testing for patients with Humana Medicare Advantage, commercial and select Medicaid plans. This is an updated version of a previous presentation. This presentation includes a printable tip sheet. Runtime: 14:12

View video presentation here , Drug Testing and Codes (2019-2020), opens new window

Professional Component/Technical Component (PC/TC)

Updated: March 2020. Learn about Humana’s policies for proper reporting and reimbursement of the professional and technical components of a service for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. Runtime: 12:44

View video presentation here , Professional Component/Technical Component (PC/TC), opens new window

Modifiers 96 and 97 (Habilitative and Rehabilitative Services)

Updated: January 2020. Learn about Humana’s policy requiring the use of modifiers 96 and 97 (habilitative and rehabilitative services) when submitting claims for many of your patients covered by Humana commercial plans. This presentation includes a printable tip sheet. Runtime: 14:25

View video presentation here , Modifiers 96 and 97 (Habilitative and Rehabilitative Services), opens new window

Modifier 25

Updated: January 2020. Learn about Humana’s policy on the use of modifier 25 when submitting claims for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. Runtime: 12:26

View video presentation here , Modifier 25, opens new window

Multiple Evaluation and Management (E/M) Services

Updated: January 2020. Learn about Humana’s policy for reimbursement of multiple E/M services for physicians and other professional providers submitting claims for patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. Runtime: 12:14

View video presentation here , Multiple Evaluation and Management (E/M) Services, opens new window

Emergency Department E/M Reimbursement

Released: November 2019. Learn about Humana’s policy for reimbursing in-network facility claims for emergency department evaluation and management services rendered to patients with Humana Medicare Advantage plans, and for reimbursing claims submitted by all facilities, in-network and out-of-network, for patients with commercial plans. This presentation includes a printable tip sheet. Runtime: 15:35

View video presentation here , Emergency Department E/M Reimbursement, opens new window

Medicare Advantage Preventive Services

Updated: November 2019. Learn about Humana’s policies for preventive services for your patients with Humana Medicare Advantage plans. Topics covered include the Initial Preventive Physical Examination (IPPE), Annual Wellness Visit (AWV), Annual Preventive Physical Exam and Well Woman Exam. This presentation includes a printable tip sheet. Runtime: 19:48

View video presentation here , Tools and Resources for Healthcare Providers, opens new window

Medicare Advantage Preventive Services – Federally Qualified Health Center

Released: November 2019. Learn about Humana’s policies for preventive services rendered in federally qualified health centers (FQHCs) for your patients with Humana Medicare Advantage plans. Topics covered include the Initial Preventive Physical Examination (IPPE), Annual Wellness Visit (AWV), Annual Preventive Physical Exam and Well Woman Exam. This presentation includes a printable tip sheet. Runtime: 21:49

View video presentation here , Medicare Advantage Preventive Services - Federally Qualified Health Center, opens new window

Medicare Advantage Preventive Services – Rural Health Clinic

Released: November 2019. Learn about Humana’s policies for preventive services rendered in rural health clinics (RHCs) for your patients with Humana Medicare Advantage plans. Topics covered include the Initial Preventive Physical Examination (IPPE), Annual Wellness Visit (AWV), Annual Preventive Physical Exam and Well Woman Exam. This presentation includes a printable tip sheet. Runtime: 21:26

View video presentation here , Medicare Advantage Preventive Services - Rural Health Clinic, opens new window

Modifiers 76 and 77

Released: November 2019. Learn about Humana’s policy on the use of modifiers 76 and 77 to indicate that a service is a repeat procedure. This presentation applies to claims submitted for professional and facility services for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. It includes a printable tip sheet. Runtime: 9:43

View video presentation here , Tools and Resources for Healthcare Providers, opens new window

Genetic Testing: Billing and Coding for Medical and Laboratory Providers

Released: October 2019. Learn about Humana’s billing expectations for coverable medically necessary genetic testing and how Humana will adjudicate and reimburse for those covered services. This information applies to claims submitted for your patients with Humana Medicare Advantage, select commercial and select Medicaid plans. The presentation includes a printable tip sheet. Runtime: 19:11

View video presentation here , Genetic Testing: Billing and Coding for Medical and Laboratory Providers, opens new window

Use of Non-Specific Procedure Codes

Updated: July 2019. Learn about Humana’s requirements for submission of non-specific, or unlisted, CPT or HCPCS codes for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. Runtime: 14:31

View video presentation here , Use of Non-Specific Procedure Codes, opens new window

Anatomical Modifiers

Updated: July 2019. Learn about Humana’s policy requiring the use of anatomical modifiers when submitting claims for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. Runtime: 14:47

View video presentation here , Anatomical Modifiers, opens new window

Procedure-to-Procedure Code Editing

Updated: June 2019. Learn about Humana’s code editing for incidental, mutually exclusive and unbundled code combinations. This information applies to claims for your patients with Humana Medicare Advantage, commercial or select Medicaid plans. This presentation includes a printable tip sheet. Runtime: 13:51

View video presentation here , Procedure-to-Procedure Code Editing, opens new window

Humana’s Approach to Code Editing

Updated: May 2019. Learn about Humana’s approach to code editing for claims for your patients with Humana Medicare Advantage, commercial and Medicaid plans. This presentation includes a printable overview. Runtime: 11:41

View video presentation here , Humana’s Approach to Code Editing, opens new window

Humana’s Maximum Unit Values

Updated: May 2019. Learn about Humana’s approach to maximum unit values for your patients with Humana Medicare Advantage, commercial and Medicaid plans. This presentation includes a printable tip sheet. Runtime: 12:08

View video presentation here , Maximum Unit Values, opens new window

Disclaimer: The information in these presentations is general and does not represent individual member benefits, coverage or payment determinations made by Humana; nor does it supersede any determination made by Humana. It does not guarantee claim payment and should not be used as legal advice or a legal opinion. As claims policies and guidelines change, the information in these presentations may be updated to reflect those changes. For Humana member claim or benefit information, please call the number on the back of the member’s ID card.

Stay connected

Be the first to know when new content is available. 

Email address * Enter a valid email
Practice/Facility Name *

How can we make this better for you? 

Let us know what you think.

Fill out feedback form

Close up of a stethoscope on top of a clipboard and a doctor in the background.