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Humana GN-00229-HD 2007 4.8 Satisfied (135 Votes)
Humana GN-00229-HD 2004 4 Satisfied (38 Votes)
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If an underpayment is identified during the review and the healthcare provider is owed payment by Humana, the healthcare provider may be asked to submit a corrected claim to receive additional reimbursement.
Time frames to submit a claim Medicare Advantage: Claims must be submitted within one year from the date of service or as stipulated in the provider agreement. Commercial: Claims must be submitted within 90 days from the date of service if no other state-mandated or contractual definition applies.
If you paid for services from your provider, ask us to reimburse you. You may request reimbursement by mailing a copy of your Humana member ID card and the provider's bill to the claims address written on the back of your card. Make sure the bill shows the patient's name and Humana member ID number.
claims have to be submitted within 12 months of when you received care. If a claim isn't filed within 12 months, Medicare can't pay its share.
Two ways to submit a claim. Valid National Provider Identifiers (NPIs) are required on an electronic claim submission and strongly encouraged on a paper claim submission. If a paper claim does not have all necessary NPIs, it may be denied or be subject to delays in adjudication.
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Commercial: Claims must be submitted within 90 days from the date of service if no other state-mandated or contractual definition applies.
All claims must be submitted within 90 days to 15 months after you receive a healthcare service. See your plan's Proof of Loss period for details on the specific timeframe. Register with MyHumana to manage your benefits online, view your plan information and policies, and get the most from your Humana health plan.
How long does Medicare reimbursement take? Medicare takes at least 60 days to process a reimbursement claim. If you have not yet paid your doctors, be sure to communicate with them to avoid bad marks on your credit.
Humana Gold Plus® Integrated (MMAI) Call 1-800-787-3311 (TTY: 711), Monday \u2013 Friday, 8 a.m. \u2013 8 p.m., Central time. Insurance through employers. Call 1-800-448-6262, Monday \u2013 Friday, 8 a.m. \u2013 9 p.m. Dental and vision. Call 1-877-877-1051, Monday \u2013 Friday, 8 a.m. to 8 p.m.
Providers have 365 days from the date of service or discharge to submit a corrected claim. Humana \u2013 CareSource ensures that no punitive or retaliatory action is taken against a member or service provider who files a grievance or appeal or a provider who supports a member's grievance or appeal.

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