1-833-502-20131-833-502-2013

Behavioral Health Resources

Behavioral Health Resources

Quick Links

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1-833-502-2013

Provider Navigators are available:

8 AM – 5 PM ET, Monday - Friday.

Working in Availity

Availity is the preferred partner of Author by Humana for all electronic transactions. The Quick Start Guide linked below includes step-by-step walkthroughs for common transactions in Availity.

Availity Logo

Availity Quick Start Guide, pdf opens new tab
Author by Humana ID Card Sample & Plan Information, pdf opens new tab

Please Note: Author by Humana uses a different Payer ID than Humana. If your practice is using a Clearinghouse or EHR/EMR to electronically submit eligibility verifications, authorizations, or claims through Availity, please confirm plans with service from Author by Humana have been configured with Author Payer ID: 61108.

Behavioral Health Prior Authorizations & Concurrent Review

The Author by Humana Right Care (Utilization Management) Team will intake all requests for behavioral health prior authorization. For out-of-network providers treating patients with an HMO plan, prior authorization is required. For all providers treating patients with service from Author by Humana in an inpatient setting, prior authorization is required. Please complete either the Outpatient or Inpatient Clinical Review Form below to request prior authorization.

Author by Humana Prior Authorization List (PAL), pdf opens new tab

PAL Archive, pdf opens new tab

Outpatient Clinical Review Form, pdf opens new tab

Inpatient Clinical Review Form, pdf opens new tab

Electronic Submission Options:

Availity


Electronic Data Interchange

Payer ID: 61108

Other Options:

Fax:

1-833-301-1006

Mail:

Author Right Care

PO Box 254

Sidney, NE 69162

Discharge Planning

We recognize the many challenges you face in navigating patients’ benefits and coordinating care. Our Author Behavioral Health Team is made up of locally based licensed social workers who are committed to working with you and your patients to help coordinate necessary services, including counseling and referrals, upon patient discharge.

For additional information about the type of Author tools and services that are available to you and your patients, see our Behavioral Health Menu of Services document below.

Release of Information & Coordination of Care Form, pdf opens new tab

Discharge Summary Form, pdf opens new tab

Claims Submission & Payment

If your practice is enrolled in ERA/EFT with Humana, those payment preferences will carry over to payments from Author by Humana. There is no separate ERA/EFT enrollment process. You can enroll or make changes via the ERA/EFT Tool in either Humana or Author by Humana’s Availity Payer Space.

Disputes Quick Start Guide, pdf opens new tab

How To Enroll in EFT, pdf opens new tab

Electronic Submission Options:

Availity


Electronic Data Interchange

Payer ID: 61108

Other Options:

Fax:

1-949-579-2964

Mail:

Author Claims

PO Box 253

Sidney, NE 69162

Please Note: If a claim is identified as overpaid, Author by Humana may send a written notice of overpayment within the applicable timeframe. Author by Humana follows state regulations, provider contract requirements, and CMS provisions when processing overpayments and recoupments. For more information, contact our Provider Navigators.

For Prescribers

Prior Authorizations for Part B & Part D Medications are managed by Humana's Clinical Pharmacy Review Team (HCPR). A request must be submitted and approved in advance for medications requiring a prior authorization. The Prescriber Quick Reference Guide linked below includes Electronic & Other Submission Options.

Prescriber Quick Start Guide, pdf opens new tab


All Grievances & Behavioral Health Appeals

Humana will receive all grievances and appeals. For additional detail on how to submit, see the Reconsiderations and Appeals page linked below.