Get paid faster

Have your Humana claims payments deposited automatically with electronic funds transfer (EFT) and electronic remittance advice (ERA). Visit Humana.com/EpaymentInfo for more information on EFT and ERA.

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.

Find in-network pharmacies

Under “Provider Groups,” select Pharmacy.

Claims submission procedures

Out-of-network claims

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

The Humana Healthy Horizons in Louisiana Provider Manual, PDF includes additional information about emergency and post-stabilization care services.

Claims payment inquiries

Learn about our claims payment processes and get answers to frequently asked questions about getting your claims paid.

Claims payment inquiries

Payment integrity and disputes

View our policies and procedures for ensuring claims accuracy and handling payment discrepancies.

Payment integrity and disputes

Reconsiderations and appeals

Get information about medical claim payment reconsiderations and member appeals for Humana participating and nonparticipating physicians, hospitals, and other healthcare providers.

Reconsiderations and appeals

Looking for help?

Compliance requirements

Review and complete required annual compliance training modules.

Documents and forms

Find the documents and forms you need, including your Provider Manual.

Contact us

If you have questions, find the number you need to get help and support.