stethoscope

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.

Resources

Two female healthcare workers research information on a laptop

The Louisiana Department of Health (LDH) makes available informational bulletins that summarize policies and procedures. This information is intended as a quick reference and is accurate on the date of issue. We encourage you to review the Humana Healthy Horizons® in Louisiana Provider Manual and contract, as requirements may differ or change.

Louisiana Department of Health informational bulletins

Centers for Disease Control and Prevention HEAR HER campaign

The Centers for Disease Control and Prevention (CDC) launched recently an initiative called HEAR HER, which includes information, stories, and resources for providers with pregnant patients in their panel. Learn how preventing maternal deaths and complications starts with listening.

CDC HEAR HER campaign

Disaster support

We’re here to help you in the event of a disaster. We will post information about any flexibilities that we’re putting in place to help you and our members.

We also include below key resources that may help you in the event of a disaster:

CMS Quality, Safety, and Oversight Group

Louisiana Department of Health emergency preparedness for providers

State of Louisiana disaster preparedness information

Mental health disorders and related topics

The National Institutes of Health (NIH) makes available information on mental health disorders and related topics for your patients and their families, health professionals, and the public. Information is available in English and Spanish. Topics include:

Anxiety disorders

Attention-deficit/hyperactivity disorder (ADHD)

Autism spectrum disorder

Bipolar disorder

Depression

Eating disorders

Obsessive-compulsive disorder (OCD)

Personality disorders

Post-traumatic stress disorder

Stress

Suicide

Access information from the NIH

Behavioral health quality monitoring program review tool

Applied Behavior Analysis (ABA) quality monitoring tool

Addictive disorders services

Substance use and related disorders services are provided statewide by each regional human service district/authority or through us for our members. The Louisiana Department of Health makes available a listing of levels of care or programs offered for substance use and related disorders.

Tobacco cessation

Quit With Us, Louisiana makes available expert quit coaches to help our members, plus the resources and support they need. Support is available 24/7.

Gambling addiction resources

Gambling addiction treatment is free for Louisiana residents. The Louisiana Association on Compulsive Gambling offers confidential support via phone, email, text, and live chat. Phone support is available 24/7.

Phone: 1-877-770-STOP (7867)

Email: lacg@helpforgambling.org

Access an e-screener to help identify someone who may need help

COVID-19

Benefit and network updates for Humana members

Go365 for Humana Healthy Horizons

Our members can sign up for Go365 for Humana Healthy Horizons®, a wellness program that offers an opportunity to earn rewards for taking healthy actions.

Relias

Humana Healthy Horizons providers have access to Relias—a web-based library available through your secure Availity account.

Through Relias, you can explore topics like:

Addiction

Behavioral health

Integrated care

Mental health

To access the Relias library, please:

Sign in to your Availity account

Select Humana Healthy Horizons in Louisiana under the Payer Spaces tab

Select the Resources tab

Select Relias Behavioral Health Training

These behavioral health-focused training modules provide integrated information to support comprehensive care and address unique member needs. The extensive Relias library offers courses designed to improve the likelihood of success in the emerging value-based healthcare delivery system. You also can earn continuing education credits by completing these courses.

Learn more about Relias training

Care Coordination Portal (population health module)

The Care Coordination Portal allows providers to monitor clinical measures and care coordination completed for members assigned to their panel. Access this portal by: 

Signing in to Availity

Navigating to the Humana Healthy Horizons in Louisiana Payer Spaces section

Selecting Resources

The Louisiana Medicaid Care Management link will direct providers to the population health dashboard. This allows providers to view member assessments, care plans, authorizations, assigned care management programs, and contact information for the member’s care manager.

Learn more about using the Altruista population health module

Medical Record Documentation Review Guidelines

Medical record reviews are performed by the Humana Healthy Horizons quality improvement team as part of regulatory requirements and can provide insight into healthcare provider strengths as well as areas of opportunity. The team conducts these reviews on randomly selected records every 2 years. The acceptable compliance score is 85%, with a goal of 90%. A compliance rate below 85% will result in a reaudit of medical record documents within 6 months. For more information, see the review guidelines below.

Provider Tip Sheets

VFC Billing FAQ’s

Medical Record Documentation Review Guidelines

Louisiana Department of Health bulletins

Louisiana Medicaid

Looking for help?

Compliance requirements

Documents and forms

Contact us