Provider sharing a brochure with a patient.

Provider education and training

At Humana, we believe one of the foundational elements for a great partnership is to supply critical and insightful training and education for our provider network. Outlined below you will see both our philosophy and commitment to supporting you via training and education to successfully provide services to Humana Healthy Horizons® in Florida members. 

Provider education objectives

Humana Healthy Horizons believes the key to engaging healthcare providers is to develop a partnership with a common goal of delivering quality care to our members. Humana Healthy Horizons will support you and your business, delivering a best-in-class experience through a robust provider engagement strategy and support structure to ensure you have what you need to:

  • Transition successfully to the new Medicaid managed care model
  • Understand your rights and responsibilities when participating within the Humana Healthy Horizons network
  • Clearly understand Humana Healthy Horizons’ policies to ensure compliance
  • Access useful tools, resources and educational materials on how to do business with Humana, including navigating our systems and care management model
  • Deliver high quality, evidence-based clinical care that drives value and performance

Provider training schedule

Behavioral health training

Behavior Analysis Provider Quick Guide

Behavior Analysis Informational flyer

Behavioral health integration initiative

Billing guides

Florida provider Anesthesia Billing Guidance

Humana Billing Rules for Medicaid ID, NPI, Taxonomy and Address Validation for Claims—English

Humana Billing Rules for Medicaid ID, NPI, Taxonomy and Address Validation for Claims—Spanish

Long-acting Reversible Contraception (LARC) Coverage with Inpatient Services billing guide

MediKids vaccines billing and service guidelines

Medical foster care provider billing/claims payment guide

Managed Medical Assistance (MMA) Nursing Facility Short Stay Admission Notification report template

Nursing Facility Custodial Care Services Provider Billing and Resource Guide

Provider CMS requirement for NPI

Provider guidance for abortions, sterilizations and hysterectomies

Provider guidance for revenue code 771 – effective Jan. 1, 2021

Vaccines for Children (VFC) Billing and Service Guideline

Case management education materials

Controlling and Managing Sickle Cell Disease (SCD)

Humana Healthy Horizons in Florida clinical programs

Humana Healthy Horizons in Florida case management recommendations for asthma

Humana Healthy Horizons in Florida case management recommendations for chronic obstructive pulmonary disease (COPD)

Humana Healthy Horizons in Florida case management recommendations for heart failure

Humana Healthy Horizons in Florida case management recommendations for diabetes

Florida telephonic Medicaid case management referral form (all regions)

Claim processing updates for taxonomy and National Provider Identifier (NPI) requirements

The Agency for Health Care Administration (AHCA) released guidance pertaining to updates to the Provider Master List (PML) effective for dates of service starting March 1, 2022. Humana Healthy Horizons processes claims in accordance with this logic and guidance, generating denials when the appropriate taxonomy, ZIP code or address information are not billed for providers with multiple active Medicaid IDs and specialties. Our goal is to partner with you to assist in preventing future denials. 

Claim processing updates for taxonomy and NPI requirements

Access to care requirements for Humana Healthy Horizons members

Electronic visit verification (EVV) claims submission requirements effective June 21, 2021

Expanded benefit—hepatitis A vaccine for adults coverage information

Humana Healthy Horizons in Florida American Rescue Plan Acts (ARPA) home- and community-based services (HCBS) payment request information

Humana Healthy Horizons in Florida Member Handbook

Compliance training

The Centers for Medicare & Medicaid Services (CMS) and state Medicaid contracts mandate that all Humana-contracted healthcare providers complete compliance program requirements each year.

Healthcare providers must complete annual compliance training requirements by Dec. 31 each year on:

  • Cultural humility, health equity and implicit bias 
  • Health, safety and welfare (abuse, neglect and exploitation) 
  • Humana Healthy Horizons in Florida provider orientation and training

We recommend completing the compliance training via your secure Availity Essentials™ account (registration required). After completing the training, an attestation of completion must be submitted through Availity Essentials.

How to complete your compliance training

  • Training is available through Availity Essentials .
  • Log in to Availity Essentials and select Payer Spaces > Humana > Humana Learning Center.
  • Select the category Compliance trainings.
  • Search for the current year training by state, making sure to complete training for any state in which you are contracted.
  • If you have not yet registered on Availity Essentials, this document will guide you through the process: Register and Get Started with Availity Essentials

Compliance requirements for healthcare providers—Answers to frequently asked questions

HHAeXchange training

HHAeXchange is the EVV vendor for Humana Healthy Horizons. Explore training materials for HHAeXchange by visiting  this link . 

MMA Physician Incentive Program (MPIP) education materials

Humana MPIP Year 9 Plan Program Summary

Humana MPIP Year 8 Plan Program Summary

Humana MPIP Year 7 Plan Program Summary

Humana MPIP Year 6 Plan Program Summary

Humana MPIP Year 5 Plan Program Summary

Humana MPIP Year 4 Plan Program Summary

Provider manuals and resource guides

The Humana Healthy Horizons provider manuals and resource guides contain important information. Check back regularly, as Humana Healthy Horizons updates materials periodically through the year.

2025 Humana Healthy Horizons in Florida Provider Manual – effective February 1, 2025

Refer to the Healthcare Provider Resource Guide for information about resources available to healthcare providers.

Florida Provider Education Guide

Refer to the Humana Healthy Horizons in Florida Provider Resource Guide for a list of departments and personnel that can assist with the coordination and authorization of services to help you treat our Humana Healthy Horizons members. 

Claim Form Provider Resource Guide

Expanded Benefits Provider Resource Guide

Long-Term Care Provider Resource Guide

Availity Essentials High-level Overview for New Users

Provider Quick Guides

Adult day care provider quick guide

Assisted living facility provider quick guide

Durable medical equipment quick guide

HIV/ AIDS quick guide

Home health provider quick guide

Humana Healthy Horizons in Florida after-hours guidelines

OB-Gyn quick guide

Primary care provider quick guide

Private duty nursing quick guide

Serious mental illness quick guide

Skilled nursing facilities quick guide

Telehealth quick guide

Reporting Florida Medicaid early intervention services, targeted case management and therapy services

Learn about Humana Healthy Horizons’ approach to early intervention services (EIS), targeted case management (TCM), therapy services, claim submission guidelines and other related processes. This presentation applies to claims submitted for services rendered to children younger than 3 enrolled in Humana Healthy Horizons. This presentation includes a printable tip sheet.

View the Reporting Florida Medicaid EIS, TCM and therapy services presentation (sign-in required)

Early intervention services in child health targeted case management services 

Screening, Brief Intervention and Referral to Treatment

Screening, Brief Intervention and Referral to Treatment (SBIRT) is an evidence-based practice used to identify, reduce and prevent problematic use, abuse and dependence on alcohol and recreational drugs. 

The goal is to improve the identification of perinatal women using substances and provide clinical care and coordination for them. The educational material below provides training on SBIRT, guidance on implementation and resources for healthcare providers.

SBIRT educational presentation

SBIRT educational video (sign-in required)

Social determinants of health education materials

Addressing social determinants of health (SDOH) provider quick guide

Food insecurity SDOH provider quick guide

Loneliness and social isolation SDOH provider quick guide

Transportation SDOH provider quick guide

Statewide Medicaid Managed Care: Continuity of care provisions

Health and dental plans are required to ensure continuity of care (COC) during the transition period for Statewide Medicaid Managed Care (SMMC)-enrolled Medicaid recipients. COC requirements ensure members transfer without a service lapse between health plans, service providers and service delivery systems (e.g., fee-for-service to managed care).

AHCA has instituted the following COC provisions:

  • Healthcare providers should not cancel appointments with the current patient.
  • For 60 days after the rollout date in each region, health plans must honor any ongoing treatment authorized prior to the recipient’s enrollment into that plan. 

Continuity of Care Provisions program highlights

Continuity of Care information—SMMC plan

Other miscellaneous training

Patient-centered medical home

Changes to patient designation for SMI

Doula services provider training for billing and claims payment

Florida statewide Medicaid managed care plan reference guide for Hospice Medicaid Services

How to access Relias

Information about long-acting reversible contraceptives (LARCs)

Patient-centered medical home training

Provider request to transfer process

Telemedicine Quick Start Guide

Training for Medicaid-participating obstetricians and gynecologists

Florida Alcohol and Drug Abuse Association (FADAA) Community Calendar

Florida Medicaid

  • Humana Healthy Horizons in Florida
  • Behavioral health
  • Claims and payments
  • Clinical coverage policies
  • Communications and network notices
  • Contact us
  • Education and training
  • Join our network
  • Long-term care
  • Pharmacy
  • Prior authorization
  • Provider resources