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Únase a nuestra red y encuentre información de acreditación.

Ingrese a Availity Essentials™ para acceder a los beneficios de los pacientes, información de reclamaciones y más.

Encuentre herramientas y materiales para ayudarle a trabajar con nosotros.

Conozca más acerca de las investigaciones y tendencias que tienen un impacto en su consultorio.

Encuentre información de autoservicio y números de teléfono, y actualice los datos de su proveedor.

Ver todos los recursos para trabajar con nosotros

Revise las listas de autorizaciones previas para obtener orientación sobre los servicios, medicamentos y envíos.

Información sobre el envío de autorizaciones previas

Autorización previa de medicamentos administrados por profesionales

Herramienta de búsqueda de autorización previa

Información sobre autorizaciones previas

Encuentre pautas sobre apelaciones e información sobre las políticas de pago.

Conozca cómo enviar reclamaciones y encontrar orientación sobre la codificación.

Pautas para la codificación de reclamaciones

Encuentre políticas sobre procedimientos, dispositivos y medicamentos.

Ver todos los recursos de cobertura y reclamaciones

Revise las pautas y programas de salud para ayudar a sus pacientes y su consultorio.

Ver todos los recursos de atención de pacientes

Encuentre beneficios, herramientas y recursos dentales.

Encuentre herramientas y recursos de farmacia.

Autorización previa para medicamentos recetados por profesionales 

Encuentre recursos específicos de cada estado para Humana Healthy Horizons® (Medicaid).

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Vea planes, conozca acerca de Medicare y explore recursos para afiliados.

Busque proveedores médicos, de la vista, dentales y de farmacia en la red.

Los afiliados deben ingresar para administrar su plan.

Materiales para capacitación para proveedores de Humana Healthy Horizons in Florida

Un profesional del cuidado de la salud anota algo en el expediente clínico de un paciente

The Centers for Medicare & Medicaid Services (CMS) and state Medicaid contracts mandate that all Humana-contracted physicians and other healthcare providers complete compliance program requirements each year.

Compliance training

All healthcare providers must complete annual compliance training requirements by Dec. 31 each year on the following topics:

Humana Healthy Horizons in Florida provider orientation and training

Cultural competency

Health, safety and welfare (abuse, neglect and exploitation)

We recommend completing the compliance training via your secure Availity Essentials account (registration required). After completing the training, an attestation of completion must be submitted through Availity Essentials.

How to complete your compliance training and submit an attestation online

Unless otherwise instructed:

Sign in to Availity Essentials.

Select Payer Spaces – Humana.

Select the Resources tab.

Select Humana Compliance Events.

If a security warning pops up indicating you are navigating to https://sso2.archer.rsa.com, choose Yes to proceed. You will be entering Humana’s secured compliance portal.If you are directed to select a Humana Partner option—please select Availity SSO and select the Remember my selection box so you can skip that option in the future.



Follow the on-screen instructions to add, review and accept the compliance events.

After you complete your training and attestations, please select 'Actions - Complete' and then 'Save and Close'

All applicable events should show a status of 'Review Complete.'

Sign out in the upper right corner of the screen when all applicable events show Complete.

Humana Healthy Horizons in Florida provider orientation and training – effective Jan. 1, 2023

This training includes information about Humana and Humana Healthy Horizons® in Florida, covered services, expanded services, contracting and credentialing, access-to-care requirements, preauthorization and notification and other key topics we want our providers to have. We base these topics on our contract with the Agency for Health Care Administration and on current Humana policies and procedures.

Cultural competency training

This training includes information about culture, cultural competence, clear communication, various subcultures and populations, strategies for working with seniors and people with disabilities and additional information we want our providers to have.

Health, safety and welfare education training

This training includes information about abuse; neglect; exploitation; interventions; “handle with care” measures; reporting abuse, neglect or exploitation; rights of mandated reporters; general reporting requirements; critical incidents; and information about Florida agencies.

For more information about the required annual training and completing the training via Availity Essentials:

Annual compliance training reminder notice – Medicaid managed medical assistance (MMA)

Annual compliance training reminder notice – Long-term care (LTC)

Compliance requirements for healthcare providers – Answers to frequently asked questions

How to complete the training via Availity Essentials

How to complete the training manually (for providers who are unable to register online and complete via Availity Essentials)

Learn about required training for providers with panels that include Humana members with Special Needs Plans (SNPs)

Attestation form

If you complete the trainings manually, please fill out and return the Compliance Requirements Attestation form, after completing the required compliance trainings. You must complete these trainings and return an attestation form each year.

Compliance Requirements Attestation form

Other training

Screening, Brief Intervention and Referral to Treatment (SBIRT)

SBIRT is an evidence-based practice used to identify, reduce and prevent problematic use, abuse and dependence on alcohol and recreational drugs. The goal is to improve the identification of clinical care and coordination for perinatal women using substances. The educational material below provides training on SBIRT, guidance on implementation, and resources for healthcare providers.

SBIRT educational presentation

SBIRT educational video

Doula provider training for billing and claims payment

Florida statewide Medicaid managed care plan reference guide for hospice Medicaid services

Addressing social determinants of health (SDOH) physician quick guide

Food insecurity SDOH physician quick guide

Loneliness and social isolation SDOH physician quick guide

Transportation SDOH physician quick guide

Information about long-acting reversible contraceptives (LARCs)

Training for Medicaid-participating obstetricians and gynecologists

Provider request to transfer process

Change Healthcare update

Billing guides for healthcare providers

Florida Provider Anesthesia Billing Guidance

Florida MMA and LTC billing guidance – English

Florida MMA and LTC billing guidance – Spanish

LARC coverage with inpatient services billing guide

MediKids vaccines billing and service guidelines

Medical foster care provider training and billing guide

MMA nursing facility admission notification report template

Nursing facility custodial care services provider billing and resource guide

Vaccines for children billing and service guide

Reporting Florida Medicaid EIS, TCM, and therapy services

Updated September 2023: Learn about Humana’s approach to early intervention services (EIS), targeted case management (TCM), therapy services, claims submission guidelines, and other related processes. This presentation applies to claims submitted for services rendered to children younger than 3 enrolled in Humana Healthy Horizons in Florida. This presentation includes a printable tip sheet. (Runtime: 8:39)

View the Reporting Florida Medicaid EIS, TCM and therapy services presentation

Early intervention services and child health targeted case management services

Comunicaciones y notificaciones sobre la red

Atención médica a largo plazo en Florida

Documentos y formularios para proveedores de servicios de obstetricia/ginecología

Materiales de capacitación sobre cumplimiento para proveedores de servicios de salud

Florida Medicaid