Compliance training materials for healthcare providers

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

Compliance training

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.

How to complete your compliance training and submit an attestation online

Unless otherwise instructed:

  • Sign in to Availity Essentials.
  • Select Payer Spaces – Humana.
  • Select the Resources tab.
  • Select Humana Compliance Events.
  • Select I agree to the notice that pops up to indicate you are leaving the Availity Essentials website.
  • If a security warning pops up indicating you are navigating to, choose Yes to proceed. You will be entering Humana’s secured compliance portal.
    • If you are directed to select a Humana Partner option—please select Availity SSO and select the Remember my selection box so you can skip that option in the future.
  • Follow the on-screen instructions to add, review and accept the compliance events.
  • Sign out in the upper right corner of the screen when all applicable events show Complete.

Humana Healthy Horizons in Florida provider orientation and training – effective Jan. 1, 2023

This training includes information about Humana and Humana Healthy Horizons® in Florida, covered services, expanded services, contracting and credentialing, access-to-care requirements, preauthorization and notification and other key topics we want our providers to have. We base these topics on our contract with the Agency for Health Care Administration and on current Humana policies and procedures.

Cultural competency training

This training includes information about culture, cultural competence, clear communication, various subcultures and populations, strategies for working with seniors and people with disabilities and additional information we want our providers to have.

Health, safety and welfare education training

This training includes information about abuse; neglect; exploitation; interventions; “handle with care” measures; reporting abuse, neglect or exploitation; rights of mandated reporters; general reporting requirements; critical incidents; and information about Florida agencies.

For more information about the required annual training and completing the training via Availity Essentials:

Annual compliance training reminder notice – Medicaid managed medical assistance (MMA), PDF

Annual compliance training reminder notice – Long-term care (LTC), PDF

Compliance requirements for healthcare providers – Answers to frequently asked questions, PDF

How to complete the training via Availity Essentials, PDF

How to complete the training manually (for providers who are unable to register online and complete via Availity Essentials), PDF

Learn about required training for providers with panels that include Humana members with Special Needs Plans (SNPs)

Attestation form

If you complete the trainings manually, please fill out and return the Compliance Requirements Attestation form, after completing the required compliance trainings. You must complete these trainings and return an attestation form each year.

Compliance Requirements Attestation form, PDF

Other training

Screening, Brief Intervention and Referral to Treatment (SBIRT)

SBIRT is an evidence-based practice used to identify, reduce and prevent problematic use, abuse and dependence on alcohol and recreational drugs. The goal is to improve the identification of clinical care and coordination for perinatal women using substances. The educational material below provides training on SBIRT, guidance on implementation, and resources for healthcare providers.

SBIRT educational presentation, PDF

SBIRT educational video

Doula provider training for billing and claims payment, PDF

Florida statewide Medicaid managed care plan reference guide for hospice Medicaid services, PDF

Addressing social determinants of health (SDOH) physician quick guide, PDF

Food insecurity SDOH physician quick guide, PDF

Loneliness and social isolation SDOH physician quick guide, PDF

Transportation SDOH physician quick guide, PDF

Information about long-acting reversible contraceptives (LARCs), PDF

Training for Medicaid-participating obstetricians and gynecologists, PDF

Provider request to transfer process, PDF

Billing guides for healthcare providers

Florida Provider Anesthesia Billing Guidance, PDF

Florida MMA and LTC billing guidance – English, PDF

Florida MMA and LTC billing guidance – Spanish, PDF

LARC coverage with inpatient services billing guide, PDF

MediKids vaccines billing and service guidelines, PDF

Medical foster care provider training and billing guide, PDF

MMA nursing facility admission notification report template, PDF

Nursing facility custodial care services provider billing and resource guide, PDF

Vaccines for children billing and service guide, PDF

Reporting Florida Medicaid EIS, TCM, and therapy services

Updated September 2023: Learn about Humana’s approach to early intervention services (EIS), targeted case management (TCM), therapy services, claims submission guidelines, and other related processes. This presentation applies to claims submitted for services rendered to children younger than 3 enrolled in Humana Healthy Horizons in Florida. This presentation includes a printable tip sheet. (Runtime: 8:39)

View the Reporting Florida Medicaid EIS, TCM and therapy services presentation

Early intervention services and child health targeted case management services, PDF