This page is designed to give healthcare providers quick access to current information 24 hours a day, seven days a week. Providers will also find useful information about other Humana long-term care (LTC) programs and resources.
Thank you to the healthcare providers who participate with the Humana LTC plan provider network and provide quality, accessible services to their Humana-covered patients throughout Florida.
Healthcare providers who want to work with Humana LTC online can register through the , opens new window portal at no cost. This multi-payer portal allows providers to interact securely with Humana and other participating payers all in one place. Many Humana-specific tools are accessible through the Availity portal. To learn more, call Availity at 800-282-4548 or visit the , opens new window.
Availity provides functions such as the following:
- Humana member ID card look-up
- Claims status and remittance information
- Electronic claims submission
- Authorization inquiry
Healthcare providers already registered with Availity can sign in to , opens new window and select “Login.”
Electronic Visit Verification
Beginning Dec. 1, 2019 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 fill out the following questionnaire for each organization. , PDF opens new window answers allow HHAeXchange to configure the agency’s portal. Please note that providers only need to fill out the questionnaire once, regardless of MCO contracts the provider holds. To learn more, call HHAeXchange at 855-400-4429 or visit the , opens new window website.
HHAeXchange healthcare provider functions include:
- FREE electronic visit verification (EVV) tools
- Open model EDI Integration with third party EVV Vendors
- Real-time, two-way messaging with each MCO
- Electronically receive recipient demographics, authorizations and plans of care
- Pre-bill scrubbing to ensure clean claims and accelerate revenue cycle
Provider call center number is 888-998-7735
Member call center number is 888-998-7732
Effective for dates of service beginning June 21, 2021, Humana Healthy Horizons in Florida will deny all claims for personal care services and home health services submitted outside HHAeXchange.
Claims for personal care services and home health services may only be processed outside of HHAeXchange on a case-by-case basis where 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, based on how they are set up:
- Email Humana Healthy Horizons in Florida’s Provider Resolution team at FLMedicaidResolution@Humana.com
Upon receipt, Humana Healthy Horizons™ in Florida will review each technical issue case and determine if the claim is exempt from the denial.
For questions regarding Humana Healthy Horizons in Florida’s EVV, please call HHAeXchange at 855-400-4429.