Member-Focused Guidance
Member resources range from wellness tips to condition-specific guidance.
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Toll-free, 24-hour-a-day access to a registered nurse |
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Services from Corphealth, a leader in behavioral health |
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Member Guidance
Employers have the option of requesting a personalized welcome kit for employees enrolled in a Humana plan
See our member resources for more information:
Member Guidance |
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e-PlanProfessorSM
A free electronic newsletter for Humana members – delivers helpful health news and benefits tips
See our member resources to view samples:
e-PlanProfessor |
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MyHumana
Password-protected health and benefits information
See our member resources:
MyHumana Health & Wellness
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Related Links
Fostering better health decisions and behaviors
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Resources to address specific health situations
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Program for mothers-to-be |
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Services for members with serious health conditions |
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Support for parents of children in Neonatal Intensive Care |
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Related Links
Helping members coordinate services and benefits
Pharmacy program that alerts members about lower-cost medication alternatives |
Resources to address chronic illness and long-term health
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One-on-one support to help members reach health goals |
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Specialized education and support for 19 conditions
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Provider-Focused Guidance
Some Humana Health Resources are designed to support provider decision-making and strengthen the doctor-patient relationship.
Clinical Review
In the Clinical Review process, Humana and providers can work together to be sure members receive appropriate care and get the most value from their benefits. Methods include:
Standardized review list:
- Highly recommended for all ASO business
- Continually managed for consistent service
Enhanced concurrent review process:
- Examines all inpatient admissions that Humana receives notice about – application of Solucient length-of-stay guidelines
- Case management integration to assist providers with care coordination and discharge planning
The bottom line
Humana continues to provide traditional approaches to addressing costs for customers who desire these services.
Radiology Consultation – RadConsult
This service, which is provided by HealthHelp, offers peer-to-peer support for doctors. Providers receive clinical appropriateness evaluation and consultation for MRI, CT, and PET. Consultation is available by phone, fax, or Internet. The service allows for real-time reporting of provider performance.
The bottom line
- More than 40,000 calls per month
- 96 percent completion within two hours; 100 percent within 48 hours
- Monthly savings of more than $2.6 million
These programs and tools are not insurance products and are not guaranteed under any contract. Humana is not required to provide these services.
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