Prior authorization information and routing information

Please visit Humana.com/PAL, 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:


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:


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

Avesis

For authorizations related to dental and vision services

Dental: Call 888-222-0059

Vision: Call 844-511-5760

eviCore healthcare

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 eviCore.com, 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 Prior Authorization List, PDF opens new window.

To submit a prior authorization request to New Century Health, you may:

  • Initiate an online request by signing in to New Century Health’s website, 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: