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Web Enhancements Make Your Job Easier!
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At Humana Military Healthcare Services, Inc., (Humana Military) we make every effort to provide the best service to our providers. We’ve made a number of new enhancements to the secure Provider Web portal, giving you easy access to information that impacts you and your practice.
This article reviews important Humana Military Web site updates in four areas:
- Referrals and Authorizations
- Transparency
- Pharmacy Data Transaction System
- NPI Registration and Maintenance
To access these enhancements, registered users can go to " MyHMHS for Providers" (formerly Online Provider Services) using their user ID and password.
Streamlined Referrals and Authorizations Screens
The Referrals and Authorizations screens on the Humana Military Web site have been streamlined to make both procedures simpler and more efficient. Submitting all of the necessary information online saves you time and allows you to receive an immediate approval. Note: At this time, the Referrals and Authorizations screens are not available for behavioral health services.
Web entry for new referral and authorization requests has been simplified to five steps:
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Entering Patient and Service Information
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Selecting Procedures to Perform
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Reviewing Existing Authorization to Update Duplicates
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Selecting Provider
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Entering Clinical Data
New Transparency Page
The Transparency page allows network providers to view information about practice affordability and administrative quality. It also provides access to performance measures and underlying data. This initiative is in support of Presidential Executive Order 13410, "Promoting Quality and Efficient Health Care in Federal Government Administered or Sponsored Health Care Programs."
Every provider and office location is evaluated based on two measurement categories: administrative quality and practice affordability. Each provider is assigned a rating of one or two stars for each category, if enough data exists.
Administrative quality is determined by the percentage of claims submitted electronically, the timely return of consultation reports and beneficiary complaints.
Practice affordability is evaluated by examining charges for professional services surrounding specific events of care and comparing a provider’s average allowed charges for episodes of care to those of other providers in the same state.
Keep in mind that this information is strictly for providers. There is currently no plan to share it with beneficiaries.
Pharmacy Data Transaction System (PDTS)
This feature allows you to review prescriptions filled by beneficiaries at military treatment facility pharmacies, at TRICARE retail network pharmacies and through the TRICARE Mail Order Pharmacy. Providers with an approved referral or authorization from Humana Military may access this information. PDTS allows you to conduct a thorough, real-time online assessment that screens the patient’s complete prescription history before you write a new prescription.
New NPI Registration and Maintenance Tool
This new tool makes it easy for providers to review and update their National Provider Identifiers (NPIs) with Humana Military. It allows authorized provider office personnel (administrators) to add and update NPIs for each category: individual, active, in-network providers (Type I) and business organizations (Type II).
Other features include:
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Showing a detailed list of provider names, specialty and NPI (if applied)
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Displaying the total number of providers with and without NPIs applied to their records
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Entering NPIs for all providers and locations under that Tax ID without having to log in again or use multiple usernames
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Checking the accuracy of the list of office locations that are in the Humana Military database
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Flagging office locations that are no longer active, so that Humana Military can update its records
Humana Military’s new web enhancements are designed to help you run your practice more efficiently and effectively.
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