Region 1: Escambia, Okaloosa, Santa Rosa and Walton counties
Region 6: Hardee, Highlands, Hillsborough, Manatee and Polk counties
Region 9: Indian River, Martin, Okeechobee, Palm Beach and St. Lucie counties
Region 10: Broward County
Region 11: Miami-Dade and Monroe counties
Medicaid Long-term-care Managed Care Program
Thank you to the providers who participate with the Humana American Eldercare provider network and provide quality, accessible services to our members throughout Florida.
This page is designed to give providers quick access to current information 24 hours a day, seven days a week. In addition, providers will find useful information about other Humana American Eldercare programs and resources.
If you are not currently part of Humana American Eldercare’s provider network and are interested in participating, you can find out more about becoming a provider (link opens in new window). Find updated contact information for our regional provider contracting representatives here (link opens in new window).
Providers can find more information about the Medicaid Long-term-care Managed Care Program (link opens in new window).
Providers who already are registered can sign in to the secure provider website here (link opens in new window). To register for the secure provider portal, fill in the information on our electronic billing page (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 health care providers complete compliance program requirements. Health care providers can complete this requirement online at the Availity Web Portal (registration required), the Humana.com secure provider website (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
Humana updates Child Health Check Up billing guidance – Practitioners can now bill Humana for a Child Health Check Up and a sick visit for the same date of service. Physician discretion in evaluating the degree of illness should determine if a Child Health Check Up should be performed during a visit when the child is sick.
A Child Health Check Up should not be performed on an obviously sick child, as the findings may be distorted. In these instances, it is advised that the physician treat the child for the illness and reschedule the check up. If, in the physician’s opinion, a Child Health Check Up or well-child visit can be appropriately completed, the physician is encouraged to treat or refer the child for the illness and bill the Child Health Check Up or well visit.
For questions, please contact your Humana or IASIS provider relations representative.
Smoking cessation – As part of our Healthy Behaviors program, Humana has contracted with Beacon Health Options to provide a telephonic smoking cessation counseling program for Humana MMA members. Members may self-refer or be referred by their health plan or physician by calling 1-800-221-5487.
Beacon Health Options will facilitate member enrollment via its Encompass Program, assigning the member a care coordinator or care manager. Members will be engaged in treatment with community practitioners, online and face-to-face support groups, as well as other resources that facilitate a smoke-free lifestyle. This combination of counseling and medication has shown to provide the greatest likelihood of successful treatment.
The following documents provide important resources for health care providers specific to Florida Medicaid members:
Long-term services and supports (LTSS) providers who need information regarding eligibility, authorizations and claims status for services provided before July 1, 2015, can access the Independent Living Systems (ILS) LTSS provider portal (link opens in new window) (registration required).
LTSS providers who need information regarding claims status or to enter claims for services provided July 1, 2015, through July 1, 2016, can access the Humana American Eldercare LTSS provider portal (link opens in new window) (registration required). If you have questions, please contact Humana American Eldercare e-billing at 1-561-665-4415 or via email at firstname.lastname@example.org.