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Preauthorization tool

Find answers to frequently asked questions and how to receive immediate preauthorization determinations.

A doctor clicks on a computer mouse in search of the preauthorization tool.

Humana has enhanced its approval process on the Availity web portal with a new preauthorization automation feature. This optional feature can provide immediate determinations for requests that previously may have been pended for review.

How it works

For select services on Humana’s preauthorization list, physicians or their staff now have the option to get faster approvals by answering a few clinical questions online. If all necessary criteria are met, Humana will deliver an instant approval.

Why I should use it

By choosing to complete the short questionnaire, you can streamline the authorization process for patients’ medical services. Even if an online approval is not provided immediately, the information given on the questionnaire will help Humana complete the review more quickly.

Answers that need to be provided

To save time when submitting the authorization, have on hand the relevant clinical information from the patient’s chart, including:

  • Standard authorization information, such as requesting and servicing provider and/or facility
  • Patient’s signs and symptoms and their duration
  • Related prior diagnostic tests and results
  • Related patient medications and duration
  • Relevant prior treatments or other clinical findings

Using this feature

Sign in to the Availity web portal and create an authorization request as usual.

  1. Look for a button labeled “Click to Complete Questionnaire.” This means the automation feature is available for the service.
  2. Answer the questions to receive an instant determination on your preauthorization.

For more information, refer to Humana preauthorization automation on Availity Essentials, PDF and a list of Frequently asked questions, PDF.