Humana adjudicates a claim for services provided to a plan member based on the information submitted in that claim and information related to that claim. If a physician or health care provider disagrees with Humana’s adjudication of that claim based on the information submitted, that physician or health care provider may submit a written request that includes new supporting clinical information for a dispute review of the plan’s determination. The request may be mailed to:
Please note the following limitations, as they help ensure that any request for a dispute review receives the proper consideration:
For more information, please review Humana’s claims payment policy by entering “claim disputes” in the search box
Questions may be directed to Humana provider customer service by calling 1-800-457-4708, 8 a.m. to 8 p.m. Eastern time, Monday through Friday.