Humana Medical Precertification Request Form 2025

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  1. Click ‘Get Form’ to open the Humana Medical Precertification Request Form in our platform.
  2. Begin by filling in the patient’s name, date of birth, and member/subscriber number. Ensure all information is legible to avoid delays.
  3. Next, provide the prescriber’s details including name, fax number, and contact information. This section is crucial for communication regarding the request.
  4. Indicate whether you are giving notification or requesting an advanced coverage determination by checking the appropriate boxes.
  5. Complete the drug information section by entering the drug name, strength, dosage instructions, and frequency of administration.
  6. If applicable, check boxes related to urgent reviews or clinical trials and provide any necessary additional comments or medical history that supports your request.
  7. Finally, ensure that the prescriber signs and dates the form before submitting it via fax to the provided number.

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See more Humana Medical Precertification Request Form versions

We've got more versions of the Humana Medical Precertification Request Form form. Select the right Humana Medical Precertification Request Form version from the list and start editing it straight away!
Versions Form popularity Fillable & printable
2022 4.4 Satisfied (56 Votes)
2014 4.8 Satisfied (43 Votes)
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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
You can submit a prior authorization request form by following the options below: Online: Sign in to Availity Essentials (opens in new window) to start a request. Phone: Call 844-825-7898 (Medicare), 844-825-7899 (commercial) Fax: 469-913-6941 (Please note, this fax number is not applicable to Medicaid.
Unhappy members: Humanas scores for customer satisfaction dropped in several major Medicare markets since last year, landing below the regional average in most, ing to J.D. Powers latest study. High cost limits: Humanas average maximum out-of-pocket limit on plans is the highest of the major providers.
In most cases, you have to get a referral to use a specialist in HMO Plans. Certain services, like yearly mammogram screenings, dont require a referral. What else do I need to know? If you get health care outside the plans network, you may have to pay the full cost.
Your PCP will be the provider with the best overall picture of your health and will be the one to coordinate any additional care you might need. If you were to need the care of a specialist, you would first see your PCP. Then, if needed, he or she would provide a referral to a specialist within the HMOs network.
Medicare Advantage plans are offered by private insurance companieslike Humanacontracted by the federal government. Medicare Advantage, also referred to as Medicare Part C, covers the same healthcare services as Original Medicare, except for hospice care.
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