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Provider documents and forms

Clinical practice guidelines

Humana has in place clinical practice guidelines for Humana-participating physicians and other Humana-contracted healthcare professionals. Humana periodically monitors compliance with nationally recognized clinical practice guidelines.

Review Humana’s clinical practice guidelines

Behavioral health clinical practice guidelines

Behavioral health guidelines are evidence-based treatment options for common behavioral health conditions. Derived from credible sources and reviewed semiannually by Humana psychiatrists who support the treatment options, these guidelines are a means to standardize treatment with the most effective interventions available.

Review Humana’s behavioral health guidelines

Behavioral health documents and forms

Physical health documents and forms

These documents apply to all parishes where Humana Healthy Horizons coverage is available.

Physical Health Authorization Request Form , PDF

Physical Health Outpatient Therapy Authorization Request Form , PDF

Altruista (population health module)

Altruista is our population health module. This module helps physicians monitor clinical measures identified and executed for members assigned to their panel. Access this module by:

  • Signing in to Availity
  • Navigating to the Humana Payer Spaces section
  • Selecting Resources

The Louisiana Medicaid Care Management link will direct providers to the population health dashboard. This allows providers to view member assessments, care plans, authorizations, assigned care management programs, and contact information for the member’s care manager.

Pharmacy resources

Adverse incident reporting

After learning of an adverse incident that affects one of your patients, providers are required to complete and submit the Managed Care Organization (MCO) Adverse Incident Reporting form to the patient’s Louisiana Medicaid MCO—not to the state. You must complete and submit the form within 24 hours of learning about the adverse incident. For patients with coverage through Humana Healthy Horizons in Louisiana, please fax this form to us at 1-888-305-7974.

MCO Adverse Incident Reporting form, PDF

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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.