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

Find tools and materials to support doing business with us.

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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

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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Clinical coverage policies

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Rapid Whole Genome Sequencing (rWGS) of Critically Ill Infants

Outpatient Lactation Support Provider

Out of Network/Out of State Provider Prior Authorization

Hospital Based Care Coordination of Pregnant SUD


Non-MCO Covered Codes and Services

Air Ambulance Transportation Clinicial Coverage Policy

Homebuilders Clinical Coverage Policy

Review for Readmission

Doula Services

EPSDT Personal Care Services (PCS) Clinical Coverage Policy

Chisholm Policy

Covered Benefits and Services Policy

Abortion Hysterectomy and Sterilization Policy

Timeliness of UM Determinations and Notifications Policy

Louisiana Utilization Management Program Description

UM Program Description Policy- Description

Continuity of Care and Care Transitions

MD Review

Observation Policy

Bariatric Surgery Clinical Coverage Policy

Blepharoplasty, Blepharoptosis Repair and Brow Lift Clinical Coverage Policy

Breast Surgery Clinical Coverage Policy

Cochlear Implant Clinical Coverage Policy

Continuous Subcutaneous Insulin External Infusion Pump Clinical Coverage Policy

Gender Affirmation Surgery Clinical Coverage Policy

Genetic Testing for Breast and Ovarian Cancer, Familial Adenomatous Polyposis (FAP) and Lynch Syndrome Clinical Coverage Policy

Hearing Aids Clinical Coverage Policy

High Frequency Chest Wall Oscillation Devices Clinical Coverage Policy

Home Health Clinical Coverage Policy

Hospital Bed Clinical Coverage Policy

Inhaled Nitric Oxide Clinical Coverage Policy

Intrathecal Baclofen Therapy Clinical Coverage Policy

Molecular Diagnostic Assays and Breath Testing for Transplant Rejection Clinical Coverage Policy

Osteogenic Bone Growth Stimulators Clinical Coverage Policy

Pediatric Day Health Care (PDHC) Clinical Coverage Policy

Wheelchair, Wheelchair Repairs, Standing Frame, Patient Lifts Clinical Coverage Policy

Wound Care Clinical Coverage Policy

Applied Behavioral Analysis Clinical Coverage

Crisis Intervention — Follow Up Policy

Assertive Community Treatment Policy

Individual Placement and Support Policy

Multi Systemic Therapy Policy

Functional Family Therapy Clinical Coverage Policy

Permanent Supportive Housing (PSH) Services

Utilization of LOCUS/CALOCUS Clinical Review Criteria

Therapeutic Group Therapy

Community Brief Crisis Support (CBCS)

Crisis Stabilization for Children and Adolescents

Personal Care Services (PCS) for Adults with Serious Mental Illness (SMI) Clinical Coverage Policy

Crisis Stabilization for Adults Coverage Policy

Community Psychiatric Support and Treatment (CPST) and Psychosocial Rehabilitation (PSR)

Behavioral health coverage policies

Louisiana Medicaid

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Compliance requirements

Documents and forms

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