Humana to expedite claim processing, suspend more prior authorization rules

April 3, 2020

Humana is expediting its claim review processes and suspending more prior authorization requirements amid the COVID-19 pandemic.


To ensure payment is sent to providers as quickly as possible, Humana is simplifying and expediting claim processing. The insurer said it hopes this will help ease some financial burden hospitals are facing.

Additionally, Humana is suspending prior authorization and referral requirements for all providers for patient care related to COVID-19, regardless of network affiliation. Humana is also suspending prior authorization for in-network providers for patient care that isn't directly related to COVID-19, except for transplant and genetic procedures, as well as pharmacy coverage. In lieu of prior authorization, Humana is requesting notification within 24 hours of inpatient and outpatient care.


The policies apply to individual and group Medicare Advantage plans, Medicaid plans and commercial employer-sponsored plans. 


via Becker's Hospital Review

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