Access materials to help you serve Humana Healthy Horizons® in Ohio members, meet mandatory Ohio Medicaid provider training requirements and improve your experience working with Humana Healthy Horizons.
You must complete the Medicaid compliance training if your organization has rendered or may render healthcare services for a Humana Healthy Horizons member.
Contracted healthcare providers and third parties supporting Humana’s Medicare and/or Medicaid products must train their employees and those supporting them to meet certain contractual obligations to Humana. This includes:
Visit our
The following training modules must be completed annually by healthcare providers who participate in Humana Healthy Horizons in Ohio Medicaid plans. We recommend completing the following training modules via your secure
This training module includes information about culture, cultural competence, clear communication, various subcultures and populations, strategies for working with seniors and people with disabilities, and additional information useful for serving your patients.
This training module includes information about abuse; neglect; exploitation; interventions; “handle with care” measures; reporting abuse, neglect, or exploitation; rights of mandated reporters; general reporting requirements; critical incidents; and information about Ohio agencies.
Availity Essentials™ is a secure multipayer portal that lets you interact with Humana Healthy Horizons® in Ohio and other participating payers without having to use multiple systems and remember separate usernames and passwords.
Education & Training Resources
Completion of the Pregnancy Risk Assessment Form (PRAF) is Ohio Medicaid’s preferred way for providers to notify the state and Humana Healthy Horizons of a member’s pregnancy. You can submit this information using a paper PRAF or online form.
The
As of Oct. 1, 2022, providers must utilize the Provider Network Management (PNM) module to access the Medicaid Information Technology System (MITS) portal. Providers can submit and adjust fee-for-service claims, submit prior authorization requests, submit hospice applications, and verify member eligibility. Providers also can submit cost reports for managed service providers, hospitals and long-term care.
Visit ODM’s
This module provides an overview of the federally mandated EPSDT program developed for Medicaid recipients younger than 21.
EPSDT webinar
Both “assignment” and “attribution” refer to the association between members and providers, but the terms are not interchangeable. Humana Healthy Horizons in Ohio created this module to define these terms and describe the assignment and attribution process.
Assignment and Attribution of Members to Primary Care Providers webinars
This module introduces the Humana Healthy Horizons Community Resource Program. Learn how this program helps bridge the gap between healthcare and community support, review the ways that social determinants impact health and see how to connect patients with the FindHelp program.
FindHelp webinar
Humana Healthy Horizons in Ohio works with our healthcare providers to ensure the highest quality of care for our members, and we are committed to making it easy for you and your staff to do business with us. This module of the Providers Trainings & Education Sessions walks you through the process for becoming a new Humana Healthy Horizons in Ohio provider.
Training Coming Soon
Humana is committed to a seamless and expedient credentialing and re-credentialing process. In this module of the Provider Education Series, we will cover credentialing requirements, and best practices for submitting the required documentation to Humana.
Humana Healthy Horizons annually surveys providers to measure health-plan performance. This module shares an overview of the Provider Satisfaction Survey. Watch the video to learn about the survey and how Humana uses the results to improve performance and relationships with network providers.
Provider Satisfaction Survey webinars
Humana Healthy Horizons includes home health and private duty nursing (PDN) benefits are included for all members. Humana’s Utilization Management (UM) team reviews prior authorization requests for home health and PDN services. All prior authorization requests must be submitted through
Home Health Providers and PDN webinar
Humana Healthy Horizons in Ohio offers members extra benefits, tools and services, at no cost to the member, that are not otherwise covered or that exceed limits outlined in the Ohio Plan and Ohio Medicaid Fee Schedules. These added benefits are in excess of the amount, duration and scope of those services.
In instances where an added benefit also is a Medicaid covered service, Humana Healthy Horizons administers the benefit in accordance with all applicable service standards pursuant to our contract, the Ohio Medicaid State Plan, and all Medicaid coverage and limitations handbooks. See the Value-Added Benefits training module to learn more about Humana Healthy Horizons members and their specific enhanced benefits.
This module provides an overview of how members can obtain transportation through Humana Healthy Horizons’ nonemergent medical transportation vendor, as well as how to coordinate trips with their local county office.
This module provides an overview of the Humana Healthy Horizons contracting and billing processes for doulas, nonmedical healthcare professionals who provide physical, emotional and informational support to a member giving birth.
This module provides an overview of Humana Healthy Horizons’ commitment to timely access to care and our Appointment and Availability survey. Humana Healthy Horizons members rely on us and providers to partner and deliver the right care at the right time. That means providing timely access to care.
As of June 1, 2025: