These documents apply to all counties where Humana Healthy Horizons in Ohio coverage is available.
Attached is the
Documents and resources
Get the Humana Healthy Horizons® in Ohio documents and resources you need.
When filing electronic Medicaid claims, please use Payer ID 61103 for your patients with coverage through Humana Healthy Horizons in Ohio. Please do not use Humana’s traditional Payer ID for fee-for-service claims (61101) when submitting Humana Healthy Horizons in Ohio Medicaid claims.
Learn more about filing electronic claims, PDF .
Provider documents and resources
Ohio Department of Medicaid forms
Change PCP form
You and your patient must sign the Change PCP form when submitting a request for a patient in your panel to choose you as their PCP instead of the PCP they have.
Abortion, sterilization, and hysterectomy forms
When submitting an abortion, sterilization, and/or hysterectomy procedure claim, please attach the appropriate consent form.
Notification of birth
Please use our Notification of birth form to let us know when one of your patients with Humana Healthy Horizons in Ohio coverage gives birth. Use this form to report a single birth as well as the delivery of twins or triplets. We will use this information to get a newborn Medicaid ID for each baby.
Nursing facility request form
Please submit the Ohio Medicaid Managed Care/MyCare Ohio Nursing facility request form to ask us to review your request for admission to a nursing facility. We will be unable to complete a medical necessity and level of care determination without receiving all required supporting documentation.
When completing the form, please select Humana from the dropdown under Managed Care Entity Contact Information.
Humana clinical practice guidelines
Pharmacy resources
Other resources
Communicating with Humana Healthy Horizons in Ohio
Provider relations: 877-856-5707 (TTY: 711), Monday – Friday, 7 a.m. – 8 p.m., Eastern time
24-Hour Nurse Advice Line (24/7, 365 days a year): 866-376-4827
Prior authorization for pharmacy drugs: 800-555-2546
Medicaid case management: 877-856-5707
Availity customer service/tech support/medical and behavioral health prior authorization submission support: 800-282-4548
Fraud, waste, and abuse
- Special Investigations Unit (SIU) hotline: 800-614-4126 (24/7 access)
- Ethics Help Line: 877-5-THE-KEY (584-3539)
Humana Provider Relations
Grievance and Appeal Department
P.O. Box 14546
Lexington, KY 40512-4546
Fax: 800-949-2961
Access2Care
Members can obtain transportation through Humana Healthy Horizons’ Non-Emergent Medical Transportation vendor Access2Care by calling 855-739-5986. Members may also contact the Medicaid Transportation Coordinator at the local county department of job and family services (CDJFS). The main phone number for each CDJFS is included in a list available at
DentaQuest
Humana has contracted with DentaQuest to provide members with routine and value added dental benefits.
Email:
Credentialing hotline: 800-233-1468
EyeMed
Humana has contracted with EyeMed to provide members with routine and value-added vision benefits.
Complete the application and indicate “Ohio Medicaid Network” in the “Additional Comments” field at the bottom of the form
For more information:
- Call the EyeMed Call Center at 888-581-3648
- Sign in to the
EyeMed Provider Portal (called inFocus)