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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).

compass

Shop plans, learn about Medicare and explore member resources.

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

Florida long-term care

A healthcare professional and an elderly patient hold hands

We want to thank the providers participating in the Humana Healthy Horizons® long-term care provider network for providing quality, accessible services to their Humana-covered patients in Florida.

Below, you’ll find key information, including the provider resource guide, tips on how to work with us online and notices from the Agency for Health Care Administration (AHCA).

For more information, call the:

    Provider call center at 888-998-7735

    Member call center at 888-998-7732


Become a participating provider in the Florida Medicaid program

Providers must complete an enrollment application with the AHCA to be eligible to provide services to Medicaid recipients in Florida. Complete the application online using AHCA’s online enrollment wizard.

Join our network

To join our LTC provider network, you must complete the online request form. You have to provide information about you and your license, your practice(s), and how we can reach you.

Availity Essentials

Availity Essentials® is a secure multipayer portal that lets you interact with Humana Healthy Horizons in Florida and other participating payers without having to use multiple systems or remember separate payer IDs or passwords. Many Humana-specific tools are accessible from the Humana Healthy Horizons payer space.

To learn more, call Availity Essentials at 800-282-4548, or visit Availity Essentials.

Through your secure Availity Essentials account, you can:

    Look up a Humana member’s ID card

    Check for claims status and remittance information 

    Submit electronic claims

    Ask for authorization to provide a service


Sign in to your secure Availity Essentials portal account.

Electronic visit verification (EVV)

Humana requires home healthcare providers to use the HHAeXchange portal to submit confirmed visits and bill claims. The first step in effectively working with Humana is to complete the HHAeXchange questionnaire for each organization. The answers in the questionnaire allow HHAeXchange to configure the agency’s portal. Please note that providers only need to complete the questionnaire once, regardless of multiple managed care organization (MCO) contracts the provider may hold. To learn more, call HHAeXchange at 855-400-4429 or visit HHAeXchange.

HHAeXchange healthcare provider functions include:

    Free EVV tools

    Open model electronic data interchange (EDI) integration with third party EVV vendors

    Real-time, two-way messaging with each MCO

    Electronic receipt of demographics, authorizations and plans of care

    Pre-bill scrubbing to ensure clean claims and accelerate the revenue cycle


Effective for dates of service beginning June 21, 2021, claims for personal care and home health services submitted outside of HHAeXchange will be denied unless there is a documented vendor system issue that prevents the healthcare provider from billing through HHAeXchange.

When there are technical issues between healthcare providers and HHAeXchange, providers should open a technical ticket with HHAeXchange by emailing one of the following: 

    Providers utilizing their own EVV system should email EDISupport@hhaexchange.com  

    All other providers should email FLSupport@hhaexchange.com


After following the steps outlined above without resolution, please email our Provider Resolution team at FLResolutionLTSS@humana.com

Upon receipt, we will review each technical issue case and determine if the claim is exempt from denial. 

For questions regarding EVV, please call HHAeXchange at 855-400-4429.

EVV thresholds and compliance timelines

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

All healthcare providers must complete annual compliance training requirements by Dec. 31 each year on the following topics:

    Humana Healthy Horizons provider orientation and training

    Cultural competency

    Health, safety and welfare (abuse, neglect and exploitation)


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.

Learn more about the required compliance training, including how to access the training via your Availity Essentials account

Additional information

Change Healthcare Update

Assisted living facility provider billing guidance

Comprehensive long-term care provider resource guide

Important reminder regarding assisted living and skilled living facility (ALF/SNF) authorizations

Faxed authorizations for assisted living facilities, skilled nursing facilities and hospice services

Cultural competency plan

Electronic billing via Availity Essentials

2023 Humana Healthy Horizons in Florida Provider Manual - effective October 1, 2023

Medicaid long-term managed care program

Provider directory

Provider e-billing companion guides

Provider training calendar

Additional training materials for healthcare providers

Florida statewide Medicaid managed care (SMMC) reference guide for hospice Medicaid services

This guide includes important information regarding hospice billing.

Medicaid long-term care managed care program

Compliance training for healthcare providers

Florida Medicaid