To make it quicker and easier to find claims-related information you need, many valuable resources about working with Humana are available online. Here are two you should know:
Preauthorization and notification requirements
To help ensure claims accuracy and reduce processing timelines, billing organizations may check Humana’s preauthorization and notification lists online. Lists available online include commercial fully insured, Medicare Advantage (MA), dual Medicare-Medicaid and Medicaid plans. These documents list services and medications for which preauthorization may be required. Each list includes information regarding exclusions and other details.
You can find the preauthorization and notification lists at Humana.com/PAL.
Medical claims payment policies
Humana offers a searchable list of medical claims payment policies online to improve transparency between Humana, healthcare professionals and billing organizations. This information about reimbursement methodologies and acceptable billing practices may help physicians and other healthcare professionals with the following:
• Submitting claims more accurately
• Reducing claims processing delays
• Avoiding rebilling and additional requests for information
New policies are published throughout the year. Sample topics include:
• Durable medical equipment (DME) capped rentals
• Transitional care management
• Pass-through billing
To learn more, visit Humana.com/ClaimPaymentPolicies and select a policy topic or search by keyword.