Documents and forms
Get the Humana Healthy Horizons® in Louisiana documents and resources you need.
Get the Humana Healthy Horizons® in Louisiana documents and resources you need.
These documents apply to all parishes where Humana Healthy Horizons coverage is available.
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.
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.
These documents apply to all parishes where Humana Healthy Horizons coverage is available.
The Chronic Care Management (CCM) Quality Monitoring Plan is designed to comply with the requirements specified in the Department of Justice Agreement Compliance Guide (DOJ Compliance Guide) for a monitoring plan and strategy of CCM Agencies to ensure delivery of effective CCM services program requirements are satisfactorily met. As required by the DOJ Compliance Guide and related LDH directives, our plan includes all requirements as specified by LDH.
These documents apply to all parishes where Humana Healthy Horizons coverage is available.
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:
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.
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.
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