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Web Referral/Authorization Made Easier for Providers! (Article 3) |
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Humana Military is continuously striving to improve its provider services. We take great pride in being able to offer state-of-the-art, Web-based transactions to our TRICARE providers in the South Region.
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Over half of all referral/authorization requests made by Humana Military providers are performed on the Web. To better serve its providers, Humana Military developed a comprehensive “Provider Resources” page to make the referral/ authorization process easier and more convenient. With new enhancements that enable providers to enter new or check existing referrals/authorizations online, providers can become more efficient than before. As a result, Humana Military expects that the number of online referral/authorization requests received will continue to exceed those requested by telephone or paper.
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Auto-approval of referral/authorization requests has expanded greatly over the last few months. This means Humana Military can generate a response for approval, including the requesting provider’s referral/authorization number when the confirmation is sent back, in most cases. Auto-approval can even happen before the beneficiary leaves your office. If your request requires no referral, Humana Military will respond with a message confirming that you do not need a referral/authorization.
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Humana Military is now allowing network specialists to refer patients to other network specialists. Humana Military knows that primary care managers (PCMs) can become inundated with the maintenance of ongoing referral requests. Our specialist-to-specialist referral process will prevent delays for our provider offices while ensuring continuity of care for our beneficiaries. We will continue to provide our PCMs with the confirmation notice in order to keep them informed of their beneficiary’s activity in
the network.
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All referral/authorization activity for an assigned beneficiary is available for Humana Military PCMs to view through our secure site. Approved specialty referral/authorizations are maintained in the secure site under their referral/authorization status. An active referral for an episode of care can be pulled for additional visits for the same episode of care, without having to request a
new referral. This eliminates reworking to keep the existing referral active.
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There’s no better way to reference referrals, track existing referrals and ensure the speed and accuracy of your office’s transactions. All you have to do is sign up for access and you are on your way.
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Note: At this time, behavioral health providers are not able to use the referral/authorization portion of this online tool.
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Created: July 9, 2007
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