Medicaid long-term care managed care program

We want to thank the providers participating in the Humana Healthy Horizons® long-term care provider network for providing quality, accessible services to their Humana-covered patients in Florida.

Below, you’ll find key information, including the provider resource guide, tips on how to work with us online and notices from the Agency for Health Care Administration (AHCA).

For more information, call the:

  • Provider call center at 888-998-7735
  • Member call center at 888-998-7732

Become a participating provider in the Florida Medicaid program

Providers must complete an enrollment application with the AHCA to be eligible to provide services to Medicaid recipients in Florida. Complete the application online using AHCA’s online enrollment wizard.

Join our network

To join our LTC provider network, you must complete the online request form. You have to provide information about you and your license, your practice(s), and how we can reach you.

Availity Essentials

Availity Essentials® is a secure multipayer portal that lets you interact with Humana Healthy Horizons in Florida and other participating payers without having to use multiple systems or remember separate payer IDs or passwords. Many Humana-specific tools are accessible from the Humana Healthy Horizons payer space.

To learn more, call Availity Essentials at 800-282-4548, or visit Availity Essentials.

Through your secure Availity Essentials account, you can:

  • Look up a Humana member’s ID card
  • Check for claims status and remittance information
  • Submit electronic claims
  • Ask for authorization to provide a service

Sign in to your secure Availity Essentials portal account.

Electronic visit verification (EVV)

Humana requires home healthcare providers to use the HHAeXchange portal to submit confirmed visits and bill claims. The first step in effectively working with Humana is to complete the HHAeXchange questionnaire, PDF for each organization. The answers in the questionnaire allow HHAeXchange to configure the agency’s portal. Please note that providers only need to complete the questionnaire once, regardless of multiple managed care organization (MCO) contracts the provider may hold. To learn more, call HHAeXchange at 855-400-4429 or visit HHAeXchange.

HHAeXchange healthcare provider functions include:

  • Free EVV tools
  • Open model electronic data interchange (EDI) integration with third party EVV vendors
  • Real-time, two-way messaging with each MCO
  • Electronic receipt of demographics, authorizations and plans of care
  • Pre-bill scrubbing to ensure clean claims and accelerate the revenue cycle

Effective for dates of service beginning June 21, 2021, claims for personal care and home health services submitted outside of HHAeXchange will be denied unless there is a documented vendor system issue that prevents the healthcare provider from billing through HHAeXchange.

When there are technical issues between healthcare providers and HHAeXchange, providers should open a technical ticket with HHAeXchange by emailing one of the following:

After following the steps outlined above without resolution, please email our Provider Resolution team at

Upon receipt, we will review each technical issue case and determine if the claim is exempt from denial.

For questions regarding EVV, please call HHAeXchange at 855-400-4429.

EVV thresholds and compliance timelines, PDF

Compliance training for healthcare providers

The Centers for Medicare & Medicaid Services (CMS) and state Medicaid contracts mandate that all Humana-contracted healthcare providers complete compliance program requirements each year.

All healthcare providers must complete annual compliance training requirements by Dec. 31 each year on the following topics:

We recommend completing the compliance training via your secure Availity Essentials account (registration required). After completing the training, an attestation of completion must be submitted through Availity Essentials.

Learn more about the required compliance training, including how to access the training via your Availity Essentials account

Additional information

Change Healthcare Update, PDF

Assisted living facility provider billing guidance, PDF

Comprehensive long-term care provider resource guide, PDF

Important reminder regarding assisted living and skilled living facility (ALF/SNF) authorizations, PDF

Faxed authorizations for assisted living facilities, skilled nursing facilities and hospice services, PDF

Cultural competency plan, PDF

Electronic billing via Availity Essentials

2023 Humana Healthy Horizons in Florida Provider Manual - effective October 1, 2023, PDF

Medicaid long-term managed care program, PDF

Provider directory, PDF

Provider e-billing companion guides, PDF

Provider training calendar, PDF

Additional training materials for healthcare providers

Florida statewide Medicaid managed care (SMMC) reference guide for hospice Medicaid services, PDF

This guide includes important information regarding hospice billing.