Get paid faster
Have your Humana claims payments deposited automatically with electronic funds transfer (EFT) and electronic remittance advice (ERA). Visit
Pharmacy benefit manager
Gainwell Technologies handles the Louisiana Medicaid Pharmacy Benefits Management Program for Humana Healthy Horizons® in Louisiana members. Our members must use Gainwell network pharmacies to get medications under the pharmacy benefit.
Under “Provider Groups,” select Pharmacy.
Claims submission procedures
Humana Healthy Horizons in Louisiana established guidelines for payments to out-of-network providers for preauthorized medically necessary services. These services will be reimbursed at no less than 100% of the Louisiana Medicaid fee schedule. If the service is not available from an in-network provider, Humana Healthy Horizons may reimburse that provider less than the Medicaid fee-for-service rate.
Emergency and post-stabilization care services
We cover and pay for emergency and post-stabilization care services. Post-stabilization care can include:
- The determination of the emergency and/or post-stabilization care a Humana Healthy Horizons member needs
- The delivery of emergency and/or post-stabilization care to a Humana Healthy Horizons member
Claims payment inquiries
Learn about our claims payment processes and get answers to frequently asked questions about getting your claims paid.
Payment integrity and disputes
View our policies and procedures for ensuring claims accuracy and handling payment discrepancies.
Reconsiderations and appeals
Get information about medical claim payment reconsiderations and member appeals for Humana participating and nonparticipating physicians, hospitals, and other healthcare providers.