Online Tool Provides Faster Preauthorization Determinations

When submitting preauthorization requests on the Availity Provider Portal, physicians, healthcare providers and their teams are encouraged to take advantage of Humana’s preauthorization automation feature. It can provide immediate determinations for requests that might otherwise be pended for review.

How does it work?

After submitting a preauthorization request on the Availity Portal, physicians and healthcare providers may receive the message below.

Selecting the “Click to Complete Questionnaire” button displays a short list of clinical questions. If all clinical criteria are met, Humana may deliver instant approval. Even if online approval is not provided immediately, the information provided on the questionnaire will help Humana complete a faster review. To expedite this process, physicians also may submit relevant clinical information related to the questions asked.

The feature is available for select services on Humana’s preauthorization and notification lists. Examples include some types of durable medical equipment (DME), outpatient diagnostic testing and surgery, including some types of cosmetic and plastic surgery.

For questions regarding online tools, visit Humana.com/providerselfservice.