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

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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

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Learn how to submit claims and find coding guidance.

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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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Humana Healthy Horizons in Kentucky Communications and Network Notices

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From time to time, Humana Healthy Horizons® in Kentucky send our provider partners information via network notice. These notices cover information from us as well as from the Kentucky Department for Medicaid Services (Kentucky DMS). You’ll find below network notices we’ve issued since 2020. We list these network notices in the order we issued them. Please note: The date we reference is the date of issuance and not necessarily the effective date. 

Visit our prior authorization webpage for prior authorization guidance. We strongly urge our providers to review this guidance, as it outlines changes to existing procedures and provides information on when the changes go into effect.

Electronic Visit Verification (EVV) for home health care services (HHCS) is scheduled to begin Dec. 28, 2023. HHCS providers should use EVV to document service visits as soon as possible and no later than Jan. 1, 2024. DMS expects providers to follow the adoption schedule below for EVV. As stated in the DMS Electronic Visit Verification Compliance notice, effective Jan. 1, 2025, any HHCS claim without a corresponding visit documented using EVV will be denied.

Jan. 2024: Providers must use EVV to capture data for at least 50% of service visits.

Feb. 2024: Providers must use EVV to capture data for at least 75% of service visits.

March 2024: Providers must use EVV to capture data for 100% of service visits.

Therap Services® partnered with the Cabinet for Health and Family Services (CHFS) in the commonwealth of Kentucky to bring its EVV system to providers of home health and personal care services across the state. Providers with questions about EVV for HHCS adoption rates should call Kentucky DMS at 844-784-5614 or email Kentucky DMS at 1915cWaiverHelpDesk@ky.gov. Providers with questions about the Therap system should visit the Therap Kentucky EVV website or email Therap at KYSUPPORT@therapservices.net.

Contact Information

Providers with questions can also reach out to DMS and Therap directly.

To contact DMS, call (844) 784-5614 or email 1915cWaiverHelpDesk@ky.gov.

To contact Therap, email KYSUPPORT@therapservices.net.

Medicaid public health emergency (PHE) unwinding information

Consumer alert: What to know if someone calls a Medicaid recipient about short-term health insurance products

The Public Health Emergency (PHE) ended on May 11, 2023. Kentucky began annual renewals in April 2023 and will continue renewals over 12 months.

Learn more about the PHE unwinding from the Cabinet for Health and Family Services

Learn more about the Medicaid revalidation process

Network notices

2025

Humana coverage policy updates

EviCore coverage policy updates

Therapeutic rehabilitation program

Comprehensive community support services

Behavioral Health Authorization Resumption Frequently Asked Questions

Psychoeducation, Peer Support, and Out of Network Policies

Humana Learning Center on Availity Essentials

Corrected claims reminder

Applied Behavior Analysis Reminder

Humana Healthy Horizons in Kentucky Provider Manual Update

Invoices for high-cost prescription drugs

Behavioral health authorization reinstatement

Webinar training for behavioral health authorization reinstatements - update

American Society for Addiction Medicine (ASAM) Fourth Edition

Prior Authorization for Behavioral Health Services – Rescission of the March 14, 2025 and Partial Rescission of the November 9, 2024 Letters

Kentucky Department for Medicaid Services: Resumption of Prior Authorization (PA) for Certain Behavioral Health Services

Humana Coverage Policy Updates - effective April 25, 2025

Humana Healthy Horizons in Kentucky’s partnership with ProgenyHealth®

Humana Coverage policy updates – effective March 26, 2025

Provider inquiry, grievance, contracted rate dispute, appeal and external independent review

Humana Coverage policy updates – effective February 10, 2025

Behavioral Health Policy Updates for Psychoeducation (H2027) and Peer Support Services (H0038)

2024

Kentucky Department for Medicaid Services - Vaccines for Children (VFC) billing modification

Oral Surgeon Billing Change

New Avēsis Portal Access

Medicaid Provider External Independent Review (EIR) Intake Form Network Notice

Humana Healthy Horizons in Kentucky Humana Coverage Policies Updates November 4, 2024

Humana Healthy Horizons in Kentucky Humana Coverage Policy Updates - effective August 2, 2024

Contracted Rate Dispute Form and Process Network Notice

Humana Healthy Horizons in Kentucky Humana Coverage Policy Updates - effective May 6, 2024

Urine drug testing policy

Humana Healthy Horizons in Kentucky Humana Coverage Policy Updates - effective February 12, 2024

Medicaid Physicians Certification Statement (PCS) Form for Non-Emergent Ground Transportation

2023

Annual sports physical exam

Clinical trial attestation form requirement – effective May 10, 2023

Provider relations on-site visits with primary care physicians – effective Jan 1., 2023

2021

Provider appeal time frame for medical necessity determination – Jan. 1, 2020 (posted August 31, 2021)

Kentucky Medicaid Regulation: 902 KAR 2:020 Reportable Disease Surveillance – Jan. 1, 2021

2020

Reminder: Claim submission requirements update – Dec. 1, 2020

Urine Drug Testing Policy from KDMS – July 1, 2020

Kentucky New Horizon provider newsletter

Current edition of the Kentucky New Horizon provider newsletter

Previous editions of the Kentucky New Horizon provider newsletter

Electronic visit verification for home health care services

Kentucky Medicaid