Medical Resources
Medical Resources
Quick Links
Important Information
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.
2022 Author by Humana Prior Authorization List (PAL), pdf opens new tab
PAL Archive, 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 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
Apart from those for oncology and radiation oncology, 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.
All Grievances & Medical Appeals
Humana will receive all grievances and appeals. For additional detail on how to submit, see the Reconsiderations and Appeals page linked below.