Humana Healthy Horizons^® in Oklahoma believes the key to engaging healthcare providers is to develop a partnership working toward a common goal of delivering quality care to our members. Humana Healthy Horizons will support you and your business, delivering a best-in-class experience through a robust provider engagement strategy and support structure to ensure you have what you need to:

• Transition you successfully to the new Medicaid managed care model
• Understand your rights and responsibilities when participating within the Humana Healthy Horizons network
• Understand Humana Healthy Horizons policies to ensure compliance
• Access useful tools, resources and educational materials on how to do business with Humana, including navigating our systems and care management model
• Deliver high quality, evidence-based clinical care that drives value and performance

Education and training resources on Availity Essentials

Availity Essentials™ offers free product training. Sign in to the Availity Essentials portal and select Help & Training > Get Trained to get started.

Humana Healthy Horizons offers training courses and resources on the Availity Essentials portal. Sign in to the Availity Essentials portal and select Payer Spaces > Humana > Humana Learning Center to get started.

Required compliance-based training programs

Providers must adhere to all Humana-identified, compliance-based training programs and requirements and submit a compliance attestation annually. This attestation provides agreement and assurance that all affiliated participating providers, supporting healthcare providers and staff who interact with members receive training on identified compliance material. Humana may require other training and education as necessary or requested by the Oklahoma Health Care Authority (OHCA) or any other state or federal agency.

As detailed in your provider manual, you must complete the following training annually:

• Complete these training courses in Availity Essentials:
  • Humana Healthy Horizons in Oklahoma new provider orientation 
  • Cultural humility and implicit bias training 
  • Health, safety, and welfare training
• Complete these training courses by selecting the link:
  • Reporting abuse, neglect and exploitation
  • Ethics Every Day
  • Addressing fraud, waste and abuse (FWA)
    • Your organization can create materials and train using its own FWA content, or it can use content provided on the Centers for Medicare & Medicaid Services (CMS) website.

Humana Healthy Horizons reserves the right to request evidence of an organization’s FWA training, that the organization was trained using an appropriate training module and that the organization documented processes for tracking training compliance. For more information on FWA, please see Chapter 15 of your Humana Healthy Horizons in Oklahoma Provider Manual

All contracted providers should complete compliance requirements within 30 days of notification.

Training is available through Availity Essentials.

• Once signed in to Availity Essentials, select Payer Spaces > Humana > Humana Learning Center. 
• Select the Compliance Trainings category. 
• Search for the current year training by state (for any states in which you are contracted).  

If you have not yet registered on Availity Essentials, this document will guide you through the process: Register and Get Started with Availity Essentials. 

If an individual provider is not directly contracted with Humana Healthy Horizons but is employed or contracted by a provider entity contracted with Humana Healthy Horizons, the individual provider must still complete the training.

Humana Healthy Horizons is here to help. If you have questions about required training, please contact your Provider Relations representative.