Your Practice de Humana

e-Enable Me: capacitación en Internet

Health care providers can use www.humana.com to check eligibility and benefit status, claims status verification, online referral submissions and much more. In order to help providers use the many Web tools available, Humana now offers live training sessions for these functions on the Web site. An instructor will walk participants through all of the tools and will answer any questions in real time. For more information, including a schedule of available training sessions in the next 60 days, or to sign up for training, go to www.humana.com and click on “Providers,” and then “Provider Resource Center.” Then click on “Provider Web Training and Demo” from the list on the left side of the page.

Proprietary Codes
As of January 2006, Humana offers providers more detailed explanation/reason codes via Humana’s Electronic Remittance Advice (835) form. This is in addition to the mandated Health Insurance Portability and Accountability Act (HIPAA) codes already provided. Most providers find that Humana’s proprietary explanation/reason codes are more detailed, more informational, and therefore, more actionable.

Mandated HIPAA explanation codes are in the same place on Humana’s 835 form, and now, Humana’s proprietary explanation/reason codes are available in reference segment 2110.

To view the descriptions for the proprietary codes found on Humana’s 835 form, go to www.humana.com and click on “Providers,” and then “Provider Resource Center.” Then click on “Electronic Remittance Advice (835) Request Form” on the left side of the page for more information.

For providers in markets outside of Florida and Arizona, Humana’s proprietary explanation/reason codes can also be viewed through the claims status inquiry tool on www.humana.com. After logging into the secure provider area of www.humana.com and pulling up a claims status inquiry, the proprietary codes can be accessed by clicking on the link to “View Additional Information.”

835 (Electronic Remittance Advice)
In an effort to eliminate paper and save time, providers who currently automatically post HIPAA compliant 835 files can now request to receive remittances electronically. To access the request form, go to www.humana.com and click on “Providers,” and then “Provider Resource Center.” Then click on “Electronic Remittance Advice (835) Request Form” on the left side of the page. Please note that this is available only to providers who post 835 Electronic Remittance Advice files electronically.

Online Referral/Authorization Submission
Humana encourages providers to submit referrals and request authorizations online. Submitting referrals and authorization requests online will save time, avoid unnecessary banded referrals and speed up processing time. Visit the secure area of www.humana.com (or www.availity.com in Florida) for more information.

Novedades
Humana is dedicated to helping its providers get as much information as possible from www.humana.com. The site’s functionality is constantly being enhanced, and features are often added. To keep providers informed of the Web site updates, Humana has created a “What’s New” page. From the home page, click on “Providers” and then “Provider Resource Center.” The “What’s New” link is on the list on the left.