From the Desk of the CMO John E. Crum, M.D.

 
Use the secure services on Humana Military Healthcare Services, Inc.’s (Humana Military) Web site to reduce administrative work, accelerate your TRICARE referrals, authorizations and claims transactions and, ultimately, improve patient care. Register Today!
 
Humana Military continues to enhance provider services. View the following tools and recent enhancements:

• Check eligibility, cost-shares and copayments
• Perform procedure code inquiries—check requirements for preventive care, prior authorization, TRICARE Prime referrals, and use of ambulatory surgery centers
• View and update existing referrals
• Enter new referral and authorization requests
• View electronic claims filing options
• Review and reconcile patient medications
• View educational materials about practice quality and affordability

Using the Humana Military Web site to request referrals and authorizations can reduce potential delays in care. Two-thirds of all new referrals and authorizations for TRICARE beneficiaries with civilian primary care managers are requested electronically using the Humana Military Web site. Sixty percent of those requests are approved online immediately, and more than 99 percent are approved within two working days. Additionally, Humana Military recently extended automated online approvals to include many behavioral health care services, reducing potential delays in care.
 
Providers can also update existing referrals and authorizations by changing dates, adding procedure and unit information, and changing facilities or rendering providers. Facilities may also use the Web site to adjust admission dates and enter discharge information.
 
To view recent medication histories of TRICARE beneficiaries, providers can click on “Show Rx List” located on the “Referral Details.” This feature is especially useful when reconciling medications during transitions in care and to assess patient adherence to therapies. The history includes medications dispensed by military treatment facilities (MTFs), TRICARE retail network pharmacies and the TRICARE Mail Order Pharmacy. Most specialty providers can review measures of administrative quality and practice affordability applied to individual providers or group practices based on their TRICARE experience. Humana Military assigns stars based on provider or group performance related to three quality measures: Electronic Claims Submission, Consult Report Return Rate to MTFs and Complaints. Humana Military also assigns stars to providers or groups based on their average allowed charges for episodes of care, as compared to the mean for peers in their state. Providers can view the methodology for applying these measures as well as the underlying data.
 
If your office has not already registered for secure online services, please take a few minutes to do so. Thank you for participating in the care of our TRICARE beneficiaries.