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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.

Electronic claims payment

Electronic claims payment offers you several advantages over traditional paper checks. For example, electronic claims payment can help with:

Faster payment processing

Reduced manual processes

Access to online or electronic remittance information

Reduced risk of lost or stolen checks

Fees may be associated with electronic transactions. Please check with your financial institution, merchant processor or clearinghouse for specific rates.

EFT/ERA enrollment

With electronic funds transfer (EFT), Humana deposits your claim payments directly into the bank account(s) of your choice. We also will enroll you for our electronic remittance advice (ERA), which replaces the paper version of your explanation of remittance (EOR).

Physicians and other healthcare providers can use Humana’s ERA/EFT Enrollment tool on Availity to request enrollment or update an existing enrollment. To access this tool:

Sign into Availity Essentials (registration required).

From the Payer Spaces menu, select Humana.

From the Applications tab, select the ERA/EFT Enrollment app. (If you don’t see the app, contact your Availity administrator to discuss your need for this tool.)

ERA/EFT Enrollment app flyer

About EFT

When you enroll in EFT, Humana deposits claims payments directly into the bank account(s) of your choice.

EFT payment transactions are reported with file format CCD+, which is the recommended industry standard for EFT payments. The CCD+ format is a NACHA Automated Clearing House (ACH) corporate payment format with a single, 80-character addendum record capability. The addendum record is used by the originator to provide additional information about the payment to the recipient. This format is also referenced in the ERA (835 data file). Contact your financial institution if you would like to receive this information.

Fees may be associated with EFT payments. Consult with your financial institution for specific rates.

About ERA

The ERA replaces the paper version of the EOR. Humana delivers 5010 835 versions of all ERA remittance files that are compliant with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Humana uses Availity® as the central gateway for delivery of 835 transactions. You can access your ERA through your clearinghouse or through the secure provider tools available at Availity Essentials

Fees may be associated with ERA transactions. Check with your clearinghouse for specific rates.

Virtual credit card payments

Humana teamed up with PNC Healthcare and ECHO Health, Inc. to pay claims to eligible healthcare providers via virtual credit card (VCC).

We will notify healthcare professionals and organizations prior to their enrollment in virtual card payments, and participants may opt out of the program by calling ECHO at 888-483-9212.

If you receive notification you’ve been entered into the virtual card program and you prefer to enroll in electronic remittance advice and electronic funds transfer (ERA/EFT) instead, please see the ERA/EFT enrollment information on this page and be sure to decline participation in the virtual card program by calling ECHO Health as soon as possible after receiving your virtual card program notification.

How virtual credit card payment works

VCC program participants will receive payment notification via fax or mail. Each notification contains a 16-digit number and remittance information for the claim(s) being paid. Process the virtual card as you do other card payments, by entering the 16-digit number and the full amount of the payment into your credit/debit point-of-sale (POS) terminal. You will pay your standard merchant fees, which include banking loyalty fees and Humana revenue share payments.

Dedicated help center for the VCC program

If you have questions about a VCC notification you received, wish to change your account setup, or want to decline participation in the program, call ECHO Health’s dedicated help center at 888-483-9212, Monday – Friday, 8 a.m. – 6 p.m., Eastern time.

Billing and payments