Humana Healthy Horizons in Florida

Provider and adult in exam roop with bandaged child

Prior authorization (PA) is the process by which a primary care provider (PCP) or other healthcare provider obtains approval from the plan as to whether an item, drug or service is covered, and is an important component to managed care.

Requests for PA should be made as soon as possible. If PA is required and not obtained, the result may lead to a reduction or denial of payment. Services provided without PA also may be subject to retrospective review. When retrospective reviews are performed, clinical information should be included to perform a medical necessity review. A summary of why PA was not obtained also should be included in the review.

Our PA list can be found at Humana.com/PAL. Please note the PA list is subject to change. Changes to PA requirements are posted to Humana.com/PAL a minimum of 45 days prior to the effective date of the change. Medical services and behavioral health/substance use disorder services are evaluated for addition to or removal from the PA list utilizing factors established in The Mental Health Parity and Addiction Equity Act of 2008.

PA for medications billed as medical claims

Cómo solicitar la autorización previa

AP para servicios médicos

AP para medicamentos facturados como reclamaciones médicas

AP para equipo médico duradero

AP para terapia ambulatoria

AP para ensayos clínicos

Autorización previa para el análisis conductual

PA para unidad de cuidados intensivos neonatales

Medicaid Florida

Cómo solicitar la autorización previa​​

AP para servicios médicos​​

AP para medicamentos facturados como reclamaciones médicas​​

AP para equipo médico duradero​​

AP para terapia ambulatoria​​

AP para ensayos clínicos​​

Autorización previa para el análisis conductual​​

PA para unidad de cuidados intensivos neonatales​​

Medicaid Florida​​