The following documents are provided to help physicians and clinicians locate the latest information for Humana Medical Plan:
This publication provides updates for Humana Medicaid HMO network physicians and healthcare providers in Florida.
- Coronavirus Disease 2019 (COVID-19) updates
- What you need to know about Telemedicine
- Provider enrollment requirements and resources
- MMA Physician Incentive Program (MPIP Year 5)
- Vaccination initiatives, billing and service guidelines
- Pharmacy information
- Flu season information and billing codes
Find past editions of this publication for Humana Family Medicaid HMO network physicians and healthcare providers in Florida.
Provider education materials
Breast pumps have been added to AHCA’s Medicaid Durable Medical Equipment (DME) schedule as a covered benefit when they meet the medical necessity criteria.
Statewide Medicaid Managed Care (SMMC): continuity of care (COC) Provisions
Health and dental plans are required to ensure continuity of care during the transition period for Medicaid recipients enrolled in the SMMC program. COC requirements ensure that, as enrollees transition from one health plan to another, one service provider to another, or one service delivery system to another (i.e., fee-for-service to managed care), they experience no lapse in service.
AHCA has instituted the following COC provisions:
- Healthcare providers should not cancel appointments with current patients.
- Health plans must honor any ongoing treatment that was authorized prior to the recipient’s enrollment into the plan for up to 60 days after the rollout date in each region.
MPIP Education Materials
MMA Physician Incentive Program (MPIP)
How to request other preauthorization
Except where noted, preauthorization requests for medical services may be initiated:
- Online via , link opens in new window (registration required)
- By calling Humana’s interactive voice response (IVR) line 24-hours a day at 1-800-523-0023 (Humana customer care representatives are available Monday through Friday, 8 a.m. to 8 p.m. Eastern time)
NOTE: Online preauthorization requests are encouraged. Additionally, clinical information for a medical service preauthorization request may be faxed to 1-813-321-7220.
Except where noted, preauthorization requests for medications billed as medical claims may be initiated:
- By sending a fax to 1-888-447-3430 (request forms are available at , link opens in new window
- By calling 1-866-461-7273 (available Monday through Friday, 8 a.m. to 6 p.m. Eastern time)
Except where noted, preauthorization requests for durable medical equipment (DME) may be initiated:
- For regions 1-8: by calling 1-866-856-8974, the Humana clinical intake team, (available Monday through Friday, 8 a.m. to 5 p.m. Eastern time)
- For regions 9-11: by sending a fax to 1-855-441-6941 (One Homecare Solutions) or calling 1-855-441-6900 (available Monday through Friday, 8:30 a.m. to 9 p.m., Saturday and Sunday, 9 a.m. to 5 p.m. Eastern time)
Case management education materials
MMA Provider reference materials
Florida Medicaid Virtual (Telemedicine) Visits coverage
Humana is looking for physicians who currently provide telemedicine services, or would like to learn more about this convenient alternative for Medicaid patients. The , PDF opens in new window provides information regarding telemedicine services reimbursement and Florida Medicaid’s requirements.