Humana-participating health care providers are encouraged to follow these steps when they have a claim issue:
1. Call Humana’s provider call center at
1-800-448-6262. The center’s trained representatives can answer most claims questions and can collaborate with the claims department when further review of a claim is needed.
2. Escalate the disputed claim(s) for root cause analysis by submitting a secure email to firstname.lastname@example.org, but only if the health care provider believes additional research is needed on the claims decision. The health care provider should be sure to include:
3. Look for an “Acknowledgment of Submission” email with a tracking number five to seven business days after submission.
4. Allow the claims specialist 30 to 45 days from the date of the acknowledgment notice to research and respond to the inquiry, either by phone or email.
Nonparticipating health care providers can direct claim issues to the phone number listed on the Humana member’s ID card.