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 clearly 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 drive value and performance
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:
Humana 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 provider manual, PDF.
All contracted providers should complete compliance requirements within 30 days of notification.
Humana Healthy Horizons requires network primary care providers to complete the following training:
- Screening and evaluation procedures for identification and treatment of suspected behavioral health problems and disorders
- Application of clinically appropriate behavioral health services, screening techniques, clinical coordination and quality of care within the scope of their practices
For training opportunities, visit Humana.com/ProviderWebinars.
Providers can access compliance training online via Availity Essentials™ using the following steps:
- Sign in to Availity Essentials
- Select Payer Spaces – Humana.
- Select the Resources tab.
- Select Humana Compliance Events.
- Select “I agree” to the pop-up to indicate you are leaving Availity’s website.
- If a security warning pops up indicating that you are navigating to https://sso2.archer.rsa.com, choose Yes to proceed. You will be entering Humana’s secured compliance portal.
- If directed to select a Humana Partner option, please select Availity SSO. You also can select [bold] “Remember my selection” [end bold] to bypass the question in the future.
- Follow the on-screen instructions to add, review and accept the compliance events.
- Select “Actions and Complete,” then “Save and Close.”
- All applicable events show a status of “Review Complete.”
It may take a few hours before Availity Essentials lists your training module and attestation as “completed” in your training history.
If your organization is unable to register at Availity Essentials, please visit Humana’s Availity Essentials Help document, PDF.
Please note: An attestation at the organization level must be submitted annually to Humana to certify your organization has a plan in place to comply with and conduct training on Medicaid-required topics.
If an individual provider is not directly contracted with Humana, but is employed or contracted by a provider entity contracted with Humana, the individual provider:
- Must still complete the training
- Does not need to submit an attestation to Humana
Humana Healthy Horizons is here to help. If you have questions about required training, please contact your Provider Relations representative.
