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Join our network and find credentialing information.

Log in to Availity Essentials™ to access patient benefits, claims information and more.

Find tools and materials to support doing business with us.

Learn more about research and trends that impact your practice.

Find self-service info and phone numbers and update your provider data.

Review prior authorization lists for services, medications and submission guidance.

Prior authorization submission information

Professionally administered drugs prior authorization

Find appeals guidelines and payment policy information.

Learn how to submit claims and find coding guidance.

Find policies for procedures, devices and medications.

Review guidelines and health programs to support your patients and practice.

Find dental benefits, tools and resources.

Prior authorization for professionally administered drugs 

Locate state-specific resources for Humana Healthy Horizons® (Medicaid).

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Shop plans, learn about Medicare and explore member resources.

Search for in-network medical, vision, dental and pharmacy providers.

Code edit simulations

Coding issues can slow claims processing, resulting in delayed payments. Avoid unnecessary delays by using Humana’s Code Edit Simulator to simulate potential code edits before submitting a claim.

When you enter claim information in the simulator, it instantly displays potential code edits that Humana may apply. This feedback allows you to address issues that can delay the adjudication of your claim.

If you are not registered for Availity Essentials, go to Availity.com and select “REGISTER” to sign up.

Log in to Availity Essentials and select “Humana” from the “Payer Spaces” dropdown.

Under the “Applications” tab, select “Code Edit Simulator” to access the tool. If you do not see the Code Edit Simulator, contact your Availity administrator to request access.

Download a flyer about the Code Edit Simulator

Healthcare providers can submit specific questions about code editing through Humana’s Research Procedure Code Edits tool. You can access this tool through the multi-payer Availity Essentials portal.

To submit a code-editing question on Availity Essentials:

If you are not registered for Availity Essentials, go to Availity.com and select “REGISTER” to sign up.

Once logged in, select “Humana” from the “Payer Spaces” dropdown.

Under the “Applications” tab, select, “Research Procedure Code Edits” to access the tool. If you do not see the tool, contact your Availity administrator to request access.



To use the simulator on Availity Essentials:

Submit code edit questions online