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

Medical Resources

Medical Resources

Quick Links

Lady with glasses

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.

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.

Prescriber Quick Start Guide, pdf opens new tab

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.