Humana Updates Preauthorization and Notification Lists for 2018

Doctor with patient

On Jan. 22, 2018, Humana will update its preauthorization and notification lists for all commercial fully insured, Medicare Advantage (MA) plans and dual Medicare-Medicaid plans. Preauthorization will be required for left atrial appendage closure (LAAC) device (e.g.; Watchman), lung biopsy and resection and simple mastectomy and gynecomastia surgery (excluding radical and modified), as well as additional medications delivered in the physician’s office, clinic, outpatient or home setting.

Important note regarding epidural injections: The notification letter mailed to all participating physicians and health care professionals included the following:

  • Humana will begin managing preauthorization requests for epidural injections. OrthoNet will no longer manage these services. Preauthorization requests should be submitted to Humana using Availity.com (registration required) or by calling Humana’s Interactive Voice Response line at 1-800-523-0023.

The epidural injection requirement has been revised, and OrthoNet will retain management of epidural injections.

Find all the details here.