08/15/2023

Humana

Aetna Managed Care Committee Member

Mary Stubitsch - Newland Medical Associates

Summary of Commercial Preauthorization and Notification List Changes
This list contains a summary of changes made to the current copy of the Commercial Preauthorizations and Notification LIst At human, we are dedicated to ensuring that every business decision we make reflects our commitment to improving the health and well-being of our members. To that end, we continuously evaluate our clinical programs, current medical literature, legislation, and coding practices to help our members achieve their best health. 

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Claims Payment Policy - Modifiers JW and JZ 
Medicare Advantage and Commercial Payment Policy
In addition to the policy, claims payments are subject to other plan requirements for the processing and payment of claims, including, but not limited to, requirements of medical necessity and reasonableness and applicable referral ar autharizatian requirements.

Humana expects each healthcare provider to administer drugs and biologicals, collectively referred to as drugs, efficiently and in a clinically appropriate manner. This includes using multi-dose vials or packages when available and clinically appropriate. Humana also expects providers to use the combination of available single-dose vials or packages that results in the least amount of discarded drug.

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