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Claims and payments. The links below lead to authorization and referral information, electronic claims submission, claims edits, educational presentations and more. Humana's priority during the coronavirus disease 2019 (COVID-19) outbreak is to support the safety and well-being of the patients and communities we serve.
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Feb 1, 2019 • State & Federal / Medicare. Effective for dates of service beginning January 1, 2019, the following Medicare Part B devices will be preferred to support cost-effective benefits. During precertification initiation or renewal, providers requesting a nonpreferred device will be encouraged to switch to a preferred product.

Acetaminophen Formulary non-steroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen, naproxen) Tramadol Intra-articular steroid injection (e.g., methylprednisolone, triamcinolone).
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  • Mercy Health is a medical group practice located in Fairfield, OH that specializes in Orthopedic Surgery.
  • Injections of hyaluronic acid, also known as viscosupplementation are aimed at reducing joint pain and improving the functional condition of the osteoarthritic joint, in particular, the knee.. Hyaluronic acid is a viscous and elastic substance that is normally produced by the joint and that makes up joint fluid(or "synovial fluid").The latter is rich in hyaluronic acid in its normal state,
  • The FDA-approved single dose injection of intra-articular hyaluronan (i.e., Synvisc-One) may be used in lieu of the course of 3 to 5 weekly injections when the medical policy criteria stated above has been met. Claim audits Routine claim audits have disclosed occurrences where some providers have been submitting claims for
  • Providers should be knowledgeable about BCBSIL Medical Policies. These Medical Policies serve as guidelines for health care benefit coverage decisions, which may vary according to the different products and benefit plans offered by BCBSIL. In addition to the active and pending Medical Policies, BCBSIL has included policies which are under ...
  • Hyalgan and Synvisc, or hyaluronic acid, are two injectable drugs that treat knee, hip, or ankle pain from osteoarthritis (OA). These treatments may also help you put off knee replacement surgery ...