Humana Credentialing Services

Humana Inc. is a Kentucky, Louisiana-based health insurance Corporation. It has gained more than 13 million Americans throughout the years in its health programme. Humana placed 56th on the Fortune 500 list with a turnover of 41.3 billion dollars.All certified independent doctors, including doctors, facilities and non-physicians, who fall within their reach and influence, are now credentials and re-certifications for Humana.

Credentialing Process

Humana mandates the use of Council for Affordable Quality Healthcare (CAQH) ProView, a programme that enables you to securely submit credentialing information to numerous plans and networks by entering data once. Data for applications can be submitted online at any time. This streamlined credentialing process cuts down on paperwork and saves time. It is free of charge.

Arkansas doctors and other healthcare specialists are not obliged to use Council for CAQH ProView. They should communicate with their state medical board to verify the credentialing specifications that refer to them.

To become certified for the first time, you must have an up-to-date and fully completed CAQH ProView application. Would you mind ensuring that you:

Would you please fill out all of the form’s fields?

• Include all previous and present practice sites.

• Include identification numbers such as the physicians or provider’s Social Security number, National Provider Identifier (NPI), Drug Enforcement Administration number, unique provider ID, and professional license numbers.

• Answer all questions and, if necessary, provide explanations.

• Include the attestation form, which must be signed and dated.

Would you mind sending digital copies of your?

• Curriculum vitae in month/year format, including employment history

• DEA certificate or professional license

• Certificate for Controlled Dangerous Substances (CDS)

• A copy of the face sheet of malpractice insurance

• A summary of malpractice cases that are now pending or have been settled

Please allow Humana access to the CAQH ProView request.

Requirements to be credentialed at Humana.

• The applicant, with state and federal regulatory authorities, is in good shape.

• A competent body has examined and approved the applicant supplier.

• Every three years, the state and federal regulatory authorities remain well-established and an authorized authority reviews and approves them.

• Continue to cover liability coverage.

• State License copy of facilities.

• There are current CLIA certificates.

• A signed and dated application is completed.

As already confirmed, Humana’s insurance policy covers at least 13 million Americans. It is, therefore, valid for the licensing of a human health insurance provider to network with people in a lucrative sector. With too many moving pieces, the procedure is highly laborious. Fortunately, our team will aid you with the process.

How to Apply?

Pre-Application
Before joining, Humana Health Insurance Credentialing, credentials required for practitioners to pass over any relevant information to validate their credentialing status with Humana. Humana has someone assigned to notify the practitioner of the eligibility requirements.

Submit Your Application
After the practitioner has reached Humana’s Health Insurance Credentialing criteria, they communicate an email with an application packet including all the information needed to begin.With the applying parties’ consent, Humana will continue to access application expertise on the CAQH, called the Council for Affordable Quality Healthcare (CAQH).

The applying party must provide the following application data, based on:

• Certificate from the State Drug Enforcement Agency

• Active and unrestricted license (If Applicable)

• Medicare and Medicaid eligibility, Medicaid number

• Humana clinical privileges in-hospital participation

• Letter of Interest for Humana Board Certification Insurance Credentialing

• Professional and educational training

• Five years of work experience

• Malpractice Claims History Adequate Malpractice Insurance

• Prior Sanctioning Exercises

Following Up

Humana will begin the credentialing procedure once the application packet is received. The entire process will take 45 to 60 days to finish.

During this time, the applying person will get e-mails bearing the following message:

Verification of Application Accepted.
Any absent documentation or employment information will be demanded. If any critical document or information is discovered to be missed during the process, Humana will inform the user of the application’s abandonment. Constant updates on an application’s situation, including any impediments you’ll receive at any time.

Humana Acceptance

If Humana approves a practitioner’s application, the practitioner follows Humana’s network of providers. Within the next ten business days, Humana will update the provider information in their database.

Being a Humana in-network provider, albeit time-consuming, is essential for providers to obtain insured clients by the Humana Insurance programme. We recognize that medical practitioners would rather spend their efforts on treating patients than on the time-consuming procedure of credentialing. As a result, we render a solid end-to-end credentialing solution that assists you throughout the process.

Re-Credentialing

If you are already a participating provider, you are liable for supplying credentials every year. Humana requires providers to be re-credentialed every three (3) years.

Once the elements are finished, a Physician Contracting Representative will communicate with your office to organize an appointment to collect the credentialing documents and conduct a site visit review, completing all essential documentation for submission to the review committee.

Humana Credentialing Phone number

Furthermore, the chief compliance officer, is accessible to any associate, health care provider, or business partner who has suggestions or comments on maintaining ethical behavior or identifying and preventing fraudulent or criminal misconduct, or they can contact the Ethics Office or call the Helpline at 1-877-5-THE-KEY (1-877-584-3539).

Humana Enrollment Application

At Humana, You’ll be directed to apply online with yours all proven credentials. They will verify and cross-check every single entity you put in. It includes several identification pre-requisite options to mark and prove your credibility. In this way they’ll verify all your details and on constant basis notify you about your o-going procedures and progress respectively.

You can get this enrollment application via online portal of Humana credentialing services website. Go and get enrolled yourself for the premium services you can get from them by offering reciprocate services.

Humana Enrollment Email

NetAdminCorrespodence@humana.com
The above-mentioned email-id and phone number can also be used for verifying eligibility status, advantages, and common queries.