Claims Reporting Standards
Defines Humana's expectations for reporting codes and claims data on claims billed to Humana Medicare Advantage plans and references applicable industry and CMS coding and transaction standards. Applies to providers submitting claims to Humana Medicare Advantage products.
No material clinical or coverage changes in this revision.
Claims Reporting and Payment Stance
Claims reporting and payment stance
Claims payment and processing are subject to this policy's coding and claims-data reporting expectations and to other plan-specific requirements.
Bill using one of the following
- Bill according to applicable Original Medicare and CMS guidance when available
ALL of the following
Examples of industry standards
- Current Procedural Terminology (CPT) coding standards by the American Medical Association (AMA)
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