It is important to maintain a healthy diet and weight. Patients can learn more about Humana's free nutritional counseling by calling Customer Service at 1-800-477-6931.

Humana Managed Medical Assistance (MMA) program and Long-Term Care Plan provider materials

Humana has contracted with the Agency for Health Care Administration (AHCA) to provide services to Medicaid beneficiaries through Humana Managed Medical Assistance (MMA) plans. Medicaid provides health care coverage for income-eligible children, seniors, disabled adults and pregnant women. It is funded by both the state and federal governments.

Provider Materials

Medicaid Long-term-care Managed Care Program

Thank you to the physicians and other health care providers who participate with the Humana Long-Term Care Plan provider network and provide quality, accessible services to their Humana-covered patients throughout Florida.

This page is designed to give physicians and other health care providers quick access to current information 24 hours a day, seven days a week. In addition, providers will find useful information about other Humana Long-Term Care programs and resources.

Humana Long-Term Care has improved online tools that became available on Aug. 1, 2016, including tools that give you the ability to submit claims or invoices electronically through the Availity Web Portal. To register for a demonstration of the online options available to you via Availity, please visit the Provider Training Calendar (link opens in new window) and select the date you want to attend to begin the online registration process.

Physicians and other health care providers already registered with Availity can sign in to the secure Availity provider website here and select “Login.”

To register for the Availity portal, or for information about registering or working with Availity, go to www.availity.com/humana. As of Sept. 1, 2016, the Humana Long-Term Care Provider Portal is read-only. Physicians or other health care providers can continue to check the status of claims already submitted but need to use the Availity portal to submit new transactions.

Find updated contact information for our regional provider contracting representatives here (link opens in new window).

Physicians and other health care providers can find more information about the Medicaid Long-term-care Managed Care Program (link opens in new window).

Additional helpful information:

Annual compliance training materials for health care providers

The Centers for Medicare & Medicaid Services (CMS) and state Medicaid contracts mandate that all Humana-contracted physicians and other health care providers complete compliance program requirements. Health care providers can complete this requirement online at the Availity Web Portal (registration required) or manually using the “Training Requirements for Health Care Providers Who Are Unable to Register” link below. Please refer to the following for more information:

Additional training materials for health care providers

The following documents are provided to help physicians and clinicians locate the latest information for Humana Medical Plan:

Humana provider communications and quality resources

  • Humana Florida Medicaid Vaccines for Children (VFC) Program and Child Blood Lead Screening – As part of Humana’s focus on preventive health, we want all infants and children to receive recommended immunizations and screenings. 

    Additionally, as detailed under section 1905(r)(1)(B)(iii) of the Social Security Act, Humana is required to remind physicians regarding their participation in the Vaccines for Children (VFC) program. More information regarding ordering VFC program vaccines is available on the Florida SHOTS™ website at http://flshotsusers.com. It is important to maintain adequate vaccine supplies. For information about the VFC inventory, please visit http://flshotsusers.com/sites/default/files/inline-files/Return%20and%20Waste%20January%202016_508.pdf.

    Federal regulations also require that children receive a blood screening for lead at 12 months old and at 24 months old.

    If you have questions regarding the VFC program or blood lead screenings, please contact the Humana Quality Management department at 1-305-626-5252.

  • Oncology Analytics (OA) reviews preauthorization requests for Humana-covered patients’ chemotherapy agents, supportive drugs and symptom management drugs. OA provides this service for all Humana lines of business, with the exception of TRICARE.

    Please submit all requests for chemotherapy agents, supportive drugs and symptom management drugs for your patients with Humana Medical Plan (Medicaid) coverage to Oncology Analytics.

    Choose from the following options to submit a preauthorization request:

    For more information, please refer to this FAQ , or contact your OA provider relations representative at 1-888-916-2616.

  • Florida Medicaid Coverage for Telemedicine – Humana is looking for physicians who currently provide telemedicine services, or would like to learn more about this convenient alternative for patients with Medicaid coverage. This flyer provides information regarding telemedicine services reimbursement and Florida Medicaid’s requirements.
  • Vaccine billing (link opens in new window) – Effective Oct. 1, 2017, physicians and other healthcare professionals who administer vaccines to Florida Medicaid recipients birth through age 20 will be required to submit both the vaccine product Current Procedural Terminology (CPT) code as well as the vaccine administration CPT code on the claim in order to receive reimbursement from Florida Medicaid through the fee-for-service delivery system. If more than one vaccine is administered during the same visit, each vaccine code and an administration code for each vaccine must be submitted on the claim form.
  • New urgent care centers join Humana – The following urgent care centers have joined Humana’s Medicaid network:
    • MD Now
      • Nine locations in Broward County
      • 11 locations in Miami-Dade County
      • 10 locations in Palm Beach County
    • Community Health of South Florida
      • Two locations – Cutler Bay and Homestead

    Physicians are requested to encourage their Humana-covered patients to contact their offices after-hours and to visit the nearest urgent care center when unable to be seen at their physician’s office.

    To find Humana-participating urgent care centers near your practice, visit Humana.com and choose the “Find a doctor” link.

    Humana-covered patients can find the nearest Humana-participating urgent care centers online at Humana.com using the “Find a doctor” link, or by calling Humana Customer Service at 1-800-477-6931 (TTY: 711), Monday through Friday from 8 a.m. to 8 p.m. Eastern time.

  • Provider Manual Appendix Bulletin: Humana supports physicians and clinicians to ensure safe opioid utilization (link opens in new window) – Humana is working with physicians and clinicians to address safety concerns about opioid utilization by Humana-covered patients.
  • Breast pump coverage (link opens in new window) – Electric 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. Humana will also cover breast pumps when they meet medical necessity criteria.
  • Second Quarter 2018 Updates for Physicians and Healthcare Providers – This publication provides updates for Humana Medicaid HMO network physicians and healthcare providers in Florida.

    Topics include:

    • Humana.com secure portal closure
    • New Medicaid Preauthorization List effective April 1
    • Annual compliance training
    • Medicaid ID confirmations
  • Humana Updates for Physicians and Healthcare Providers Archive (link opens in new window) – Find past editions of this publication for Humana Family Medicaid HMO network physicians and healthcare providers in Florida.

Quality resources

The following documents provide important resources for physicians and other healthcare providers specific to Florida Medicaid members:

  1. Download and customize the letter(s) for their letterheads, their communication styles and patients' needs.
  2. Distribute the letter(s) to their MMA-covered adult and/or pediatric patients, regardless of the patients' health benefits plan membership.

Long-term services and supports (LTSS) provider portal

LTSS providers who need information regarding claims status or to enter claims for services provided July 1, 2015, through Aug. 31, 2016, can access the Humana Long-Term Care LTSS provider portal (link opens in new window) (registration required). If you have questions, please contact Humana Long-Term Care at 1-561-665-4415 or via email at LTCproviderrelations@humana.com.