Provider documents and resources

Jan. 1, 2023 update – Our Moms First care management program is now HumanaBeginnings™. Your pregnant patients with coverage through Humana Healthy Horizons® in South Carolina who enroll get additional support and resources.

Important Documents

Attached is the Clinical Trial form. Please complete and return with any prior auth request for care related to a clinical trial.

Humana Healthy Horizons in South Carolina provider manual – effective April 15, 2025

Humana Healthy Horizons in South Carolina provider manual – effective July 1, 2024

Humana Healthy Horizons in South Carolina Provider Billing and Claims Guide

Humana Healthy Horizons in South Carolina Member Handbook

Humana Healthy Horizons in South Carolina Provider Resource Guide

Humana Healthy Horizons in South Carolina Behavioral Health Quick Reference Guide

Humana Healthy Horizons in South Carolina Primary Care Physician Change Request Form

Humana Healthy Horizons in South Carolina Social Determinants of Health Resource Guide

Humana Healthy Horizons in South Carolina Prior Authorization Request Form

Mental Health Resources for Teens and Young Adults English

Mental Health Resources for Teens and Young Adults Spanish

Pharmacy Resources

2025 Provider Common Prescribed Drug List

Humana Health and Wellness Catalog and Order Form – English

Humana Health and Wellness Catalog and Order Form – Spanish

Comprehensive Drug List (English)

Comprehensive Drug List (Spanish)

Summary of Comprehensive Drug List Changes – English

Summary of Comprehensive Drug List Changes – Spanish

OB-GYN provider documents

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

Abortion Statement

Consent for Sterilization

Notification of Birth form

Notification of Pregnancy form

Surgical Justification Review for Hysterectomy Patient

Go365 for Humana Healthy Horizons

Members can register for the new Go365 for Humana Healthy Horizons® wellness program and earn rewards for participating in healthy activities.

To earn rewards, members must:

  • Download the Go365 for Humana Healthy Horizons app onto a mobile device from the Apple App Store or Google Play.
  • Create an account to access and engage in the program.
    • Members younger than 18 must have a parent or guardian register on their behalf using the minor’s Medicaid member ID.
    • Members 18 or older can register and create their own Go365 accounts. They must have their Medicaid member IDs to register.

 

Members can use the same login information from MyHumana account to access Go365 for Humana Healthy Horizons.

For each eligible completed Go365 activity, members earn rewards that can be redeemed in the Go365 in-app mall. Rewards earned through Go365 are not transferrable to other managed care plans or other programs. Rewards are non-transferable and have no cash value.

Earned e-gift cards may not be used for tobacco, alcohol, firearms, lottery tickets or other items not supporting a healthy lifestyle.

For more information, please visit Humana.com/SouthCarolinaGo365 .

South Carolina Medicaid

  • Humana Healthy Horizons in South Carolina
  • Documents & resources
  • Claims
  • Communications & network notices
  • Prior authorization
  • Training materials