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Humana

This information (other than the National Health Insurer Report card results) has been provided to the AMA by Humana.

Humana home page

Provider home page

Claim and Encounter Mailing Addresses

Claim Processing Edits

Code Edit Questions
Registration required. After logging in, visit the Resources tab to find the Code Edit Question tool that allows providers to enter CPT and ICD codes to understand claim payment logic.

For an alternative method, providers may also use Availity.com in FL, TX, IL, NM, OK, KY, IN, OH, VA, GA, WI, KS, MO, CO, CA and NM.  Registration required. After logging in, click Claims Management in the left navigation pane to find Research Procedure Code Edit.

Fee Schedule Inquiry
Registration required. After logging in, visit the Resources tab to find Fee Schedule Inquiry. 

For an alternative, providers may also use Availity.com in FL, TX, IL, NM, OK, KY, IN, OH, VA, GA, WI, KS, MO, CO, CA and NM.  Registration required. After logging in, click on Claims Management in the left navigation pane to find Fee Schedules.

Financial Recovery Policies

HIPAA Companion Guides

HumanaAccess Visa Debit Card

Medical Coverage Policies

Multiple Procedure Reduction Logic  - for Surgical payments only
View page 17 of the "Provider Manual for Physicians, Hospitals, and Healthcare Providers."

Publications (provider manuals)

Policies and lists - includes comprehensive lists of services requiring prior authorization

Prior Authorization Code List

Real-Time Claim Adjudication
Learn how to bill for services at the point of service.

Medical Coverage Policies Database

Quality resources for physicians regarding prevention and wellness services

Electronic health care transactions

National Health Insurer Report Card
Review the NHIRC
for this year and past years to see how Humana stacks up on a variety of critical metrics.

Health Insurer Financial Information:

Health insurer financials
The AMA has compiled a resource that highlights health insurer SEC filing data since 2006. This resource provides information based on company filings for the seven largest national publicly traded health insurers: Aetna, CIGNA, Coventry, Health Net, Humana, UnitedHealthcare and WellPoint/Anthem.

Health insurer state fines
The AMA has compiled a resource that lists the fines health insurers have incurred in each state and the reasons for the fines. This resource underscores the importance of reporting unfair payer practices.

Health insurer CEO compensation
The AMA has compiled a resource that highlights health insurer SEC filing data, including CEO compensation since 2006. This resource provides information based on company filings for the seven largest national publicly traded health insurers: Aetna, CIGNA, Coventry, Health Net, Humana, UnitedHealthcare and WellPoint/Anthem.

LinkedIn Discussion Group
Join discussions in the AMA Administrative Simplification LinkedIn Group.