Interactive voice response (IVR) system capabilities
The IVR system provides automated information on claims, benefits and more, 24 hours a day, seven days a week.
Call the number on the back of the member’s Humana identification card to reach the IVR system.
Information available through IVR system
You can obtain a variety of information by using the IVR system.
The system can:
Confirm member coverage and the date the coverage began.
Notify you if referrals are required by the member’s plan.
Give you the status of a referral request.
Provide the member’s deductible, copayment and coinsurance information.
Provide the member’s out-of-pocket and lifetime maximum information.
Retrieve claim status for specific members.
Retrieve claim status for all your claims on one or more days.
Initiate inpatient admission and non-HMO (health maintenance organization) outpatient preauthorization requests.
Provide preauthorization request status*, directing your call to a Humana customer care representative, if needed.
In addition, you can use the system to request that the following information be sent to you by fax:
Member eligibility information.
Claims status: 40 claims per page, organized in a remit format.
*Available in most areas
The IVR system gives you the option of requesting help from a Humana customer care representative. Assistance is available Monday through Friday on the following topics:
Medical eligibility, benefits and claims status: 8 a.m. to 8 p.m. EST.
Dental eligibility, benefits and claims status: 8 a.m. to 8 p.m. EST.
Preauthorizations: 8 a.m. to 6 p.m. EST.
Financial recovery: 8 a.m. to 5 p.m. EST.
Information you will need to use IVR
Before calling the IVR system, make sure you have the following information handy:
Nine-digit tax ID number.
Nine-digit member ID number (listed on member's ID card).
Member's date of birth (mm/dd/yy).
Date of service in mm/dd/yyyy format (for specific options, such as claims or precertifications).
Your fax number (if a fax-back option is requested).
Specific information to initiate a preauthorization, including the following: CPT-4 (five-digit) codes for procedures and surgeries; ICD-9 (three-, four- or five-digit) codes for diagnoses; CPT or HCPCS codes for outpatient procedures.
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