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

Medical Resources

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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 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.

Medical Prior Authorizations

The Author by Humana Right Care (Utilization Management) Team will intake all requests for medical prior authorization except those from orthopedists, oncologists, and radiation oncologists.

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

Authorization Request Form, pdf opens new tab

Electronic Submission Options:

Availity

Electronic Data Interchange

Payer ID: 61108

Cohere Health for Orthopedists

Cohere Quick Start Guide, pdf opens new tab

New Century Health for Oncologists & Radiation Oncologists

New Century Health Quick Start Guide, pdf opens new tab

Other Options:

Fax:

1-833-301-1006

Mail:

Author Right Care

PO Box 254

Sidney, NE 69162

Claims Submission & Payment

If you receive electronic payments from Humana, those preferences will carry over to your payments from Author by Humana. Otherwise, you may receive a separate paper check and remittance advice from Author by Humana in addition to your typical Humana documents. To avoid receiving these important documents separately, you can enroll in Electronic Funds Transfer (EFT).

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

Apart from those for oncology and radiation oncology, Prior Authorizations for Part B & Part D Medications are managed by Humana's Medication Intake Team (MIT). 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 & Medical Appeals

Participating providers may appeal on the patient’s behalf using the Medical Appeal Form linked below. Non-participating providers may appeal on behalf of themselves or on behalf of the patient, accompanied by a Waiver of Liability Form or Appointment of Representative Form. 

Medical Appeal Form, pdf opens new tab

Waiver of Liability Form, pdf opens new tab

Appointment of Representative Form, pdf opens new tab

Grievance & Appeal Quick Start Guide, pdf opens new tab

Submission options:

Standard Fax:

1-833-301-1004

Expedited Fax:

1-833-301-1005

Mail:

Author Grievances & Appeals

PO Box 273

Sidney, NE 69162

Please Note: A request for an expedited appeal can be submitted if waiting for a standard response time frame could seriously jeopardize the member's life, health, or ability to regain maximum function. Expedited appeals are not used for claims that have already been paid or denied.