The links below offer details on how to request preauthorization and submit notification for various tests and procedures.
Preauthorization requests for cardiac ablation/electrophysiology study (EPS) and ablation for bone, liver, kidney and prostate disease are reviewed by HealthHelp®.
Preauthorization requests for knee, shoulder and hip arthroscopies are reviewed by OrthoNet.
Behavioral health services
Preauthorization requests for mental health and substance use services for patients with Humana commercial and Medicare Advantage (MA) coverage are managed by Humana Behavioral Health, a wholly owned Humana subsidiary.
Preauthorization determinations for cardiac interventions and devices are reviewed by HealthHelp.
Chemotherapy agents, supportive drugs and symptom management drugs
Preauthorization is required for chemotherapy agents, supportive drugs and symptom management drugs.
Diagnostic and cardiac imaging
Preauthorization requests for diagnostic and cardiac imaging are reviewed by HealthHelp.
Facility-based sleep studies (PSG) for adults
Preauthorization requests for facility-based sleep studies, also known as polysomnography (PSG), are reviewed by HealthHelp.
Preauthorization requests for bunionectomies and hammertoe surgeries are reviewed by OrthoNet.
Molecular diagnostic/genetic testing
Preauthorization is required for services related to molecular diagnostic/genetic testing (MD/GT).
Negative pressure wound therapy (NPWT)
Preauthorization may be required for initial and continued NPWT services. Forms for initiation and reauthorization of NPWT are available.
Oncology therapy services
Preauthorization requests for oncology therapy services are reviewed by HealthHelp.
Effective Dec. 18, 2017, Humana no longer requires PT/OT/ST preauthorization for patients with Humana MA or commercial coverage.
Preauthorization requests for pain management services are reviewed by OrthoNet.
Preauthorization requests for some surgical services are reviewed by HealthHelp.