1 / 4

2014 Humana

2014 Humana. Maranda Merjudio Consultant, Network Relations- Michigan. Why Register With Humana or Availity?. Secure website Humana.com Provider Self-Service Center or Availity Patient eligibility and benefits Preauthorization requests Referral authorization and claims submissions

mliss
Download Presentation

2014 Humana

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. 2014 Humana Maranda Merjudio Consultant, Network Relations- Michigan

  2. Why Register With Humana or Availity? • Secure website • Humana.com Provider Self-Service Center or Availity • Patient eligibility and benefits • Preauthorization requests • Referral authorizationand claims submissions • Referral authorization and claims status • Fee schedules • Membership roster • Code edits • Training and Help • Humana email: deployment@humana.com • Web-based training schedule: https://www.humana.com/provider/medical-providers/education/provider-self-service/interactive • What’s New: https://www.humana.com/provider/medical-providers/education/whats-new/ • Connectivity or Password Reset • 1-877-845-3480

  3. 2014 Humana • Primary care physicians initiate request for authorization or referral by submitting requests to Humana using any one of the following processes: • Humana.com (registration required) • Availity.com (registration required) • Phone: 1-800-523-0023 • Primary care physicians receive a referral number from Humana if the • request meets the following criteria: • Complete request • Service is covered • Referred provider is an in-network provider • Medically necessary • Referral status can be verified by accessing Humana.com, Availity.com or by calling 1-800-523-0023. For the most up-to-date list of in-network health care providers, please visit Humana.com and look for the “Find a healthcare provider” tab View the full Preauthorization and Notification List by product type at: www.Humana.com >Providers > Medical Providers > Education > Claims > Pre Authorization Effective Jan. 1, 2014

  4. Radiology Preauthorization: HealthHelp • Preauthorization requirements apply to CT scans, MRAs, MRIs, nuclear stress tests, PET and SPECT scans, radiation therapy and cardiac catherization 1 • For additional information about radiology, please visit https://www.humana.com/provider/support/on-demand/ and choose “RadConsult Online” • Preauthorization may be requested online or by phone • Online, visit portal.healthhelp.com/humana • By phone • Call Humana Radiology Services at 1-866-825-1550 • Representatives are available from 8 a.m. to 8 p.m. Eastern time, Monday through Friday, and from 10 a.m. to 5 p.m. Eastern time, on Saturday • Radiology services which require preauthorization may be subject to change; refer to https://www.humana.com/provider/medical-providers/education/claims/pre-authorization to verify that the service requires a preauthorization Insert form number via Header and Footer option or delete, if not needed

More Related