![]() ![]() Last Published, Services by Unlicensed Residents and Medical Students Policy, Professional - Reimbursement Policy - UnitedHealthcare Medicare Advantage. Humana has contracted with Professional Health Care Network (PHCN) for home health network management services, effective Jfor the following Medicare Advantage (MA) networks These offerings allow us to manage the needs of people enrolled in state-sponsored health coverage.Update on Humana Home Health Network Services We have extensive experience and expertise providing evidence-based, whole-person care models that integrate physical health, behavioral health, pharmacy, social services and supports. The PHCN Provider Manual can be used as an operational road map. Prior Authorization Request / Referral Form: This document provides an overview of your obligations as a PHCN Provider. In-network providers submit this form for an initial authorization request. Referring providers submit this form to initiate home health services.Ī Resumption of Care (ROC) assessment is required any time the patient is admitted as an inpatient for 24 hours or more for other than diagnostic tests. Humana, ChoiceCare and HBHN policies and procedures, claims submission and adjudication requirements and guidelines used to administer Humana health plans. In-network providers submit this form for a re-authorization request, if needed.įorm confirming start of care or resumption of care. Other policies and procedures are posted online. State-specific Medicaid provider manuals (sometimes referred to as appendices) also are available and may contain additional information. Upload this form along with completed OASIS assessment.įorm to confirm fax numbers for authorization and re-authorization requests. In-network providers submit this form to update agency information (TIN, NPI, address, etc.) Out-of-network providers submit this form to receive payment for PPO members.Įlectronic Funds Transfer (EFT) Enrollment:įorm to enroll in EFT payments. Please contact the PHCN team with any questions at: Phone: (888) 705-5274. Our Utilization Management (UM) department applies nationally recognized utilization criteria and regionally developed medical policies and standards of care for utilization management reviews. #Humana timely filing limit 2021 manualĬriteria are available to providers and practitioners upon request by calling (888) 705-5274, faxing (877) 612-7066, emailing by mail at 7600 N.#Humana timely filing limit 2021 update.#Humana timely filing limit 2021 manuals.
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