Humana Healthy Horizons in South Carolina Provider Prior Authorization

Doctor working on a laptop.

Prior authorization information and routing information

We want to help make working with us as easy as possible. Below, please find common forms related to prior authorization that you may need to use when providing services for Humana Healthy Horizons® in South Carolina members.

Prior authorization forms

Provider Notification Form , PDF opens new window

Universal Prior Authorization Form , PDF opens new window

Behavioral health prior authorization forms

Applied Behavioral Analysis Authorization Form , PDF opens new window

Electroconvulsive Therapy Authorization Form , PDF opens new window

Inpatient and Partial Hospitalization Authorization Form , PDF opens new window

Inpatient Sub-Acute Authorization Form , PDF opens new window

Intensive Outpatient Authorization Form , PDF opens new window

PHP and IOP Behavioral Health Authorization Form , PDF opens new window

Psychological and Neuropsychological Testing Authorization Form , PDF opens new window

Residential Authorization Form , PDF opens new window

Routine Outpatient Authorization Form , PDF opens new window

Requesting prior authorization

For medical services/procedures and behavioral health

Except where noted, prior authorization requests for medical services/procedures and behavioral health may be initiated:

  • Online via Availity, opens new window (registration required) Please note: Online prior authorization requests are encouraged
  • By calling Humana’s interactive voice response (IVR) line at 866-432-0001, Monday – Friday, 8 a.m. – 6 p.m., Eastern time
  • By calling our authorization intake team directly at 888-285-1114, Monday – Friday, 8 a.m. – 6 p.m., Eastern time
  • By emailing CorporateMedicaidCIT@humana.com
  • By faxing clinical information for a medical service prior authorization request form to 833-441-0950

For pharmacy drugs

Except where noted, prior authorization requests for pharmacy drugs may be initiated:

  • By calling 800-555-2546, Monday – Friday, 8 a.m. – 6 p.m., Eastern time

When applicable, please use one of the below forms when submitting an authorization request for medication, Synagis®, or Mekena.

Prior Authorization Request Form: Medications, PDF opens new window

Prior Authorization Request Form: Universal Synagis®, PDF opens new window

Universal 17P/Makena Authorization Form, PDF opens new window

Learn more about prior authorization in the Humana Healthy Horizons in South Carolina Provider Manual , PDF opens new window

South Carolina Medicaid