Please visit , opens new window for current and previous prior authorization and notification lists.
How to request prior authorization for medical services
Except where noted, prior authorization requests for medical services may be initiated:
- Online via , opens new window® (registration required)
Please note: Online prior authorization requests are encouraged
- By calling Humana’s interactive voice response line at 800-444-9137, Monday – Friday, 8 a.m. – 6 p.m., Eastern time
- By calling our authorization intake team directly at 888-285-1114, Monday – Friday, 8 a.m. – 6 p.m., Eastern time
- By faxing clinical information for a medical service prior authorization request to 833-974-0059 using the , PDF opens new window or the , PDF opens new window
How to request prior authorization for medications
As of July 1, 2021, MedImpact is the pharmacy benefits manager for all Kentucky health plans offering coverage to Medicaid enrollees. As a result, MedImpact manages all prior authorization requests for medications.
To submit a prior authorization request to MedImpact:
- Call 844-336-2676
- Fax 858-357-2612
- Use the , opens new window, , opens new window, or , opens new window web portals
Physicians and healthcare practitioners in Kentucky may use this universal claim form to submit authorization requests for their Humana Healthy Horizons in Kentucky/Medicaid-covered patients. Please follow the instructions on the form when completing and submitting it.
Please note: Send all medically billed medication prior authorization requests to Humana Healthy Horizons in Kentucky and New Century Health, as outlined below.
Prior authorization partnerships
For authorizations related to dental and vision services
Dental: Call 888-222-0059
Vision: Call 844-511-5760
As of March 1, 2021, Humana Healthy Horizons in Kentucky and eviCore healthcare partnered to provide authorization services for Kentucky Medicaid enrollees for the following advanced imaging services:
- 3D rendering
- Computed tomography angiography (CTA)
- Computerized tomography (CT) scan
- Magnetic resonance angiography (MRA)
- Magnetic resonance imaging (MRI)
- Nuclear medicine
- Positron emission tomography (PET)
- Single-photon emission computerized tomography (SPECT) scan
You can submit authorization requests to eviCore:
- By visiting online at , opens new window (registration required)
- By calling 866-672-8115, Monday – Friday, 7 a.m. – 7 p.m., Eastern time
- By faxing your request to 800-540-2406
New Century Health
For adults 18 and older, Humana partners with New Century Health for chemotherapy agent-, supportive- and symptom-management-drug prior authorization requests.
For a list of applicable medications, please see our , PDF opens new window.
To submit a prior authorization request to New Century Health, you may:
- Initiate an online request by signing in to , opens new window. If you have not yet received a username and password, please call New Century Health at 855-427-1372, Monday – Friday, 8 a.m. – 8 p.m., Eastern time, and select option 1.
- Call New Century Health’s Intake Coordinator department at 855-427-1372, Monday – Friday, 8 a.m. – 8 p.m., Eastern time, and select option 1.
WholeHealth Networks (dba Tivity)
Starting October 1, 2021, for all chiropractic services on the KDMS fee schedule, you must get prior authorization through Tivity.
To submit a prior authorization request to Tivity for chiropractic services:
- Use the , opens new window
- Call 866-430-8647, Monday – Friday, 8:30 a.m. – 5:30 p.m., Eastern time
- Fax 888-492-1025