This policy only applies to disputes concerning Humana Provider Payment Integrity’s (PPI) medical record review findings made during the adjudication of a claim or post-payment review of a claim. Humana offers healthcare providers up to 3 opportunities to dispute Humana’s medical record review findings (Levels One, Two and Three). Dispute requests are reviewed by licensed or certified personnel who were not the individuals who made the initial findings.
Please submit all levels of disputes to the following address or fax number:
Humana Provider Payment Integrity Disputes
P.O. Box 14279
Lexington, KY 40512-4279
To ensure proper routing and a thorough and timely review of your dispute, please include a copy of the completed , PDF opens new window that was attached to the original findings letter, and any other documentation related to your dispute.