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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).

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Shop plans, learn about Medicare and explore member resources.

Search for in-network medical, vision, dental and pharmacy providers.

Effectiveness and Efficiency of Care

Our methodology for evaluating effectiveness (may also be described as clinical quality) and efficiency (also described as cost-efficiency) of care is consistent with national standards and incorporates physician feedback.

For detailed information about how we evaluate  effectiveness and efficiency, please see the manual forPhysician Effectiveness and Efficiency.

To see the effectiveness and efficiency measures that apply to you, please select a specialty below and review the applicable measures.

Understanding how we measure

Find your measures

Working with us

Access Reports and Information

Prior Manuals and Guides