2014 Humana Maranda Merjudio Consultant, Network Relations- Michigan

Secure website Humana.com Provider Self-Service Center or Availity – Patient eligibility and benefits – Preauthorization requests – Referral authorization and claims submissions – Referral authorization and claims status – Fee schedules – Membership roster – Code edits Why Register With Humana or Availity? Training and Help – Humana – Web-based training schedule: providers/education/provider-self- service/interactive – What’s New: providers/education/whats-new/ providers/education/whats-new/ Connectivity or Password Reset – /23/2015

3 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: 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 Effective Jan. 1, Humana 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: >Providers > Medical Providers > Education > Claims > Pre Authorization

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 and choose “RadConsult Online” Preauthorization may be requested online or by phone – Online, visit portal.healthhelp.com/humanaportal.healthhelp.com/humana – By phone o Call Humana Radiology Services at o 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 Preauthorization: HealthHelp 4 (1)Radiology services which require preauthorization may be subject to change; refer to to verify that the service requires a preauthorization 9/23/2015 Insert form number via Header and Footer option or delete, if not needed