Code edit simulations

Coding issues can slow claims processing, resulting in delayed payments. Avoid unnecessary delays by using Humana’s Code Edit Simulator to simulate potential code edits before submitting a claim.

When you enter claim information in the simulator, it instantly displays potential code edits that Humana may apply. This feedback allows you to address issues that can delay the adjudication of your claim.

To use the simulator on Availity Essentials:

  1. If you are not registered for Availity Essentials, go to Availity.com and select “REGISTER” to sign up.
  2. Log in to Availity Essentials and select “Humana” from the “Payer Spaces” dropdown.
  3. Under the “Applications” tab, select “Code Edit Simulator” to access the tool. If you do not see the Code Edit Simulator, contact your Availity administrator to request access.

Download a flyer about the Code Edit Simulator, PDF

Submit code edit questions online

Healthcare providers can submit specific questions about code editing through Humana’s Research Procedure Code Edits tool. You can access this tool through the multi-payer Availity Essentials portal.

To submit a code-editing question on Availity Essentials:

  1. If you are not registered for Availity Essentials, go to Availity.com and select “REGISTER” to sign up.
  2. Once logged in, select “Humana” from the “Payer Spaces” dropdown.
  3. Under the “Applications” tab, select, “Research Procedure Code Edits” to access the tool. If you do not see the tool, contact your Availity administrator to request access.