Working with Humana online: Availity orientation
Availity Essentials is a multipayer site, so you need only their unique username and password to interact securely with Humana and other participating payers. This webinar provides an overview of how to use Availity Essentials to work with Humana online. Topics include:
- Checking eligibility and benefits
- Submitting referrals and authorizations
- Managing claims and payment information
- Submitting requested medical records
- Completing other secure administrative tasks online
Appeals and disputes
This webinar covers how to use Availity Essentials’ Appeals function to submit appeals and disputes for finalized Humana Medicare, Medicaid or commercial claims. You can upload needed documentation and check the status of requests that were submitted online.
Medical Resources
Authorization and referral management
This webinar covers the Availity Essentials authorization and referral submission tools, plus Humana’s Authorization Management tool. You can use Authorization Management to search for and view existing authorizations. In some cases, you can update a referral or authorization request and add attachments.
Claim management and remittance information
This webinar covers claim-related tools available on Availity Essentials, including:
- Claim status tool – Search and view submitted claims for your Humana-covered patients
- Remittance inquiry – View an electronic version of the explanation of remittance (EOR) for your payments
- Humana’s Code Edit Simulator tool – Enter code combinations and receive immediate feedback about code edit results that could be applied to similar claims processed by Humana
Eligibility and benefits
With Availity’s Eligibility and Benefits Inquiry tool, you can verify a patient’s Humana coverage and review benefit details for in-network and out-of-network providers. You can view a patient’s Humana ID card, care reminders, Humana member summary, certificate of coverage and more.
Medical records management
Humana’s Medical Records Management (MRM) tool on Availity Essentials enables sharing of medical record information between healthcare providers and requesting Humana departments. With the MRM tool, you can submit requested medical records quickly and securely (in TIF, TIFF, JPEG, JPG and PDF format), check the status of submissions and view new, completed and canceled requests.
Overpayments
The Availity Essentials Overpayments tool can help you view, research, dispute and resolve your overpayment requests online. You can even sign up to be notified when you have a new overpayment. Availity offers this