Humana will no longer require preauthorization for outpatient physical, speech and occupational therapy services for patients with commercial and Medicare Advantage (MA) coverage, effective Dec. 18, 2017. Following are some important details about this change:
- While preauthorization will no longer be required, visit limits and other plan provisions (e.g., referrals) will still apply.
- Referrals should be submitted to Humana via Availity.com (registration required) for prompt processing.
- Physicians and other health care professionals may be asked to submit medical records to substantiate the medical necessity of services that have been provided.
For additional information and to access the Humana Medical Coverage Policies, log into your Gawenda Gold Membership account and click