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Submit appeals and disputes online. Appeals and disputes for finalized Humana Medicare, Medicaid or commercial claims can be submitted through Availity’s secure provider portal, Availity Essentials™. Healthcare providers can: Upload needed documentation with online submissions.
Use our online form to file a complaint, it's fast, easy, and secure. Enter your member information to either file a complaint or to track the status of an appeal. If filing a complaint, you can choose to appeal an unfavorable coverage decision or submit a grievance.
Appeals and disputes for finalized Humana Medicare, Medicaid or commercial claims can be submitted through Availity’s secure provider portal, Availity Essentials ™. To get started: Sign in to. . Use the Claim Status tool to locate the claim you want to appeal or dispute, and then select the Dispute Claim button on the claim details screen.
If you believe that Humana has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:
Learn about claims and coverage resources for providers, billing and payments, coverage policies and prior authorizations.
Review how to dispute an overpayment as a provider. Learn more about how Humana Provider Payment Integrity (PPI) reviews claims payments for accuracy.
If you are filing an appeal or grievance on behalf of a member, you need an Appointment of Representative (AOR) form or other appropriate legal documentation on file with Humana so that you are authorized to work with Humana on his or her behalf.