Providers

Making It Easier for Physicians and Other Healthcare Providers: An educational series

“Making It Easier for Physicians and Other Healthcare Providers” is a series of educational presentations about Humana’s claims payment policies and processes. Additional materials will be added periodically.

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Common Errors — Reporting Diagnosis Codes in the Primary Position (opens in new window)  :  Learn how to avoid some common errors when reporting primary diagnosis codes for claims submitted for your patients with Humana Medicare Advantage, commercial and Medicaid plans. This is an updated version of a previous presentation, “Primary Diagnosis Codes — Common Reporting Errors.” This presentation includes a printable tip sheet. (Runtime: 15:58)
Tools and Resources for Healthcare Providers (opens in new window)  :  Learn about Humana’s inventory of useful tools and resources, which can simplify your claims-related and other interactions with Humana. Printable resource guides are included. (Runtime: 10:41)
Modifier 25 (opens in new window)  :  Learn about Humana’s policy on the use of modifier 25 when submitting claims for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This is an updated version of a previous presentation. It includes a printable tip sheet. (Runtime: 12:02)
Drug Testing and Codes (2017-2018) (opens in new window)  :  Learn about Humana’s policies on drug testing for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This is an updated version of a previous presentation. It includes a printable tip sheet. (Runtime: 17:05)
Modifiers 96 and 97 (Habilitative and Rehabilitative Services) (opens in new window)  :  Learn about Humana’s new policy requiring the use of modifiers 96 and 97 (habilitative and rehabilitative services) when submitting claims for many of your patients with Humana commercial plans. This presentation includes a printable tip sheet. (Runtime: 8:42)
Professional Component/Technical Component (opens in new window)  :  Learn about Humana’s policies for proper reporting and reimbursement of the professional and technical components of a service for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This is an updated version of the previous presentation. It includes a printable tip sheet. (Runtime: 11:38)
Multiple Evaluation and Management (E/M) Services (opens in new window)  :  Learn about Humana’s policies for reimbursement of multiple E/M services for physicians and other professional providers submitting claims for patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. (Runtime: 12:38)
Anatomical Modifiers (opens in new window)  :  Learn about Humana’s policy requiring the use of anatomical modifiers when submitting claims for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. (Runtime: 15:18)
Use of Non-Specific Procedure Codes (opens in new window)  :  Learn about Humana’s requirements for submission of non-specific, or unlisted, CPT or HCPCS codes for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. (Runtime: 13:27)
Humana’s Maximum Unit Values (opens in new window)  :  Learn about Humana’s approach to maximum unit values for your patients with Humana Medicare Advantage, commercial and Medicaid plans. This presentation includes a printable tip sheet. (Runtime: 12:39)
Medicare Preventive Services (opens in new window)  :  Learn about Humana’s policies for coverage of preventive services for your patients with Humana Medicare Advantage plans. Topics covered include the Initial Preventive Physical Examination (IPPE), Annual Wellness Visit (AWV), Annual Preventive Physical Exam and Well Woman Exam. This presentation includes a printable tip sheet. (Runtime: 21:57)
Procedure-to-Procedure Code Editing (opens in new window)  :  Learn about Humana’s code editing for incidental, mutually exclusive and unbundled code combinations, including application of the Centers for Medicare & Medicaid Services’ (CMS’) National Correct Coding Initiative. The information provided applies to claims for your patients with Humana Medicare Advantage, commercial and Medicaid plans. This presentation includes a printable tip sheet. (Runtime: 13:49)
Application of Medicare NCD/LCD Guidelines (opens in new window)  :  Learn how Humana administers Medicare national coverage determinations (NCDs), local coverage determinations (LCDs) and related articles for your patients with Humana Medicare Advantage plans. This presentation includes a printable tip sheet. (Runtime: 9:52)
Humana’s Approach to Code Editing (opens in new window)  :  Learn about Humana’s approach to code editing for claims for your patients with Humana Medicare Advantage, commercial and Medicaid plans. This presentation includes a printable overview. (Runtime: 11:25)
Modifier 24 (opens in new window)  :  Learn about Humana’s policy on the use of Modifier 24 to indicate an unrelated evaluation and management (E/M) service by the same physician or other qualified health care professional during a postoperative period. The information provided applies to your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. (Runtime: 12:29)
Modifiers 59 & X{EPSU} (opens in new window)  :  Learn about Humana’s policy on the use of Modifiers 59 & X{EPSU} when submitting claims for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. (Runtime: 13:17)
Bilateral Services and Modifier 50 (opens in new window)  :  Learn about Humana’s policies for reporting bilateral services and the use of modifier 50 for services provided to your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. (Runtime: 9:16)
Home Health Billing (opens in new window)  :  Learn about Humana’s guidelines for submitting home health service claims for your patients with Humana Medicare Advantage, commercial and Medicaid plans. This presentation includes a printable tip sheet. (Runtime: 20:19)
Chronic Care Management Services (opens in new window)  :  Learn about Humana’s policy for coverage of the chronic care management services codes when submitting claims for your patients with Humana Medicare Advantage and select Medicaid plans. This presentation includes a printable tip sheet. (Runtime: 11:57)
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