Physicians or other healthcare providers who receive a medical record request from Humana may send medical records, itemized bills, invoices and other documentation via one of the following options:
To ensure the medical records are indexed correctly, please attach the medical record request letter for each claim from Humana.
If the address or healthcare provider name is incorrect on the medical record request, contact the Humana Provider Payment Integrity (PPI) Customer Service Department at 1-800-438-7885. You may leave a message 24 hours a day, seven days a week and provide the correct information. Please specify if the address applies to any other location associated with the facility and/or the healthcare provider.
You can verify that records have been received by Humana by logging in to the Medical Records Management tool (see above) or by contacting the Humana PPI Customer Service Department at 1-800-438-7885. This line is open 24 hours a day, seven days a week.
Humana will send the original request and will then generate a new request every 30 days until the request has been fulfilled or a technical denial is issued for failure to respond to a request for medical records. If records have been sent, but requests continue to be received, please contact the Humana PPI Customer Service Department for assistance. Please refer to the Humana Provider Payment Integrity Technical Denial Policy.
All invoices should be routed through the MRM system. Humana does not prepay for records, and reimbursement is made once record requests are fulfilled.
Humana will follow all applicable federal and state laws and regulations, Humana policies and procedures and any applicable contract language. When more than one state is impacted by a particular issue, to allow for consistency, Humana will follow the most stringent requirement(s). This standard is subject to change or termination by Humana at any time. Humana has full and final discretionary authority for its interpretation and application.