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RCM Advisor

Quarter 2 2023 - Volume 28, ISSUE 2

Q&A: Humana

Feature Article

By RCM Advisor Editors


Q. What detailed claim status information is available on your website?

A. Humana provides detailed claim status through Availity Essentials at Availity.com. Providers have the ability to look up a claim status by member ID, claim number, or service dates. The response includes details such as line level detail, reason/remark codes, category/status codes.


Q. What is the most efficient way to reach a live person?

A. Please reference humana.com/provider/contact for specific contact numbers.


Q. Credentialing is painful for everyone. Is there a plan to add automation to your process? Have you considered making the application date the participation date?

A. At this time, Humana does not have an automated process for credentialing.  


Q. What is the best way to check on claim status?

A. Using the Claim Status tool in Availity Essentials at Availity.com is the best way to check claim status.


Q. Are you able to add the date and address where a check is mailed to on your website?

A. Humana provides detailed remittance information including check date and address through the Humana Remittance Inquiry tool via Availity.com.  


Q. Do you require authorizations in an emergency situation? Do you have an automated process for obtaining an authorization?

A. Humana evaluates emergency situations on a case by case basis. Humana utilizes Availity.com for electronic authorizations submission and status inquiry.