Humana adopts clinical practice guidelines based on guidance from national organizations generally considered experts in their fields. Humana's YourPractice features updates to these clinical practice guidelines as well as newly adopted guidelines. Humana intends to provide timely information about evidence-based best practices for patient care and to help improve quality measures and Stars scores. While many guidelines are updated annually, others may not change for several years. Humana encourages physicians and other practitioners to look for these clinical practice guideline notifications in Humana's YourPractice. Medical and behavioral health clinical practice guidelines are available here.
Humana's medical and pharmacy coverage policies are based on evidence published in peer-reviewed medical literature, technology assessments obtained from independent medical research organizations, evidence-based consensus statements and evidence-based guidelines from nationally recognized professional health care organizations.
Information about medical and pharmacy coverage policies can be found at Humana.com/provider by selecting "Medical and Pharmacy Coverage Policies" under "Resources." Medical and pharmacy coverage policies can be reviewed by name or revision date. Users may also search for a particular policy using the search box. More detailed information may be found by reviewing "How to Read a Medical Coverage Policy" and "Understanding the Medical Coverage Policy Development Process."
Below are the new and revised policies:
No pharmacy coverage policies with significant revisions
Humana's "Education on Demand" tool provides physicians, other practitioners and their office staff with quick, easy-to-understand information on topics that should simplify doing business with Humana.
To access this tool, health care providers may choose: https://www.humana.com/provider/support/on-demand/. If a computer with a sound card is not available or if the computer is not configured for streaming audio, the presentations may be accessed via telephone while viewing the slides on screen. To begin the telephone playback process, health care providers should follow these steps:
Available topics are as follows:
Humana’s claims education page includes educational tools that help health care providers better understand Humana’s claims policies and processes. To access the tool, physicians and health care providers can visit Humana.com/healthcareproviderhowto.
The page, which will be updated with new content each month, has brief education-on-demand computer-based presentations that include a printable tip sheet with the most important information about each topic. Current topics include:
The presentations can be accessed around the clock.
Health care providers who want to learn more about how they can save time, increase efficiency and help improve the productivity of their practice should plan to attend this introductory webinar. These sessions for office staff last between 45 minutes and one hour.
To register, visit Humana.com/providerwebinars.
Confirmation and instructions on how to access the online webinar will be sent via email within 48 hours of the request.