Humana has partnered with onehome as a value based convener of Home Health, DME and Infusion services in order to streamline the processes for referrals and authorizations, to improve care coordination.

onehome can assist with all Humana patients’ Home Health, DME, and Infusion needs, and with any issues encountered, whether that be by assisting with clinical care, understanding covered services for easier PPI audits, coordinating DME or medication delivery, or be a conduit for facilitating issue resolution. When you receive an order from onehome, you can expect a clean order with an authorization for confirmed eligible patients. You just need to do what you do best – start the patient’s care.

onehome will check eligibility and prepare referrals for your agency. When you receive a referral it will include a clean order, with patient demographics and an authorization for initial visits. With centralized care coordination, onehome resolves all patient issues/questions, and covers all supplies.

This change benefits patients through improved care coordination. If you are currently seeing patients, there will be no change in your ability to continue services. For any new patients or start of care visits, DME and infusions will be available consistently for their visits.

Beginning June 1, 2022 authorizations must be sent to onehome for Richmond, Roanoke, and Southern Virginia. Beginning September 1, 2022 authorizations must be sent to onehome for Northern Virginia, Charlottesville, Tidewater, and Fredericksburg to enable effective care. All your current contracts with Humana will remain intact.

Authorization requests can be made electronically via fax: 1-855-475-5614

onehome will provide responses on authorizations within CMS designated timeframes. All providers should be sure to submit requests timely to avoid delays in services.

Concurrent authorization requests can be made electronically via fax: 1-855-475-5614

There will be no change in claims processes or payment at this time, but onehome will act as a liaison between you (the provider) and Humana. Providers must ensure that an authorization is on file with onehome in order to facilitate these conversation.

Concurrent authorization requests can be made electronically in our onecare portal or via fax at 1-855-441-6941.

Claims need to be submitted through VisilbilEDI and our Payer ID is ONEHC. For additional questions regarding getting set-up, please go to http://info.visibiledi.com/ for information on direct submission to VisibilEDI.

Claim status can be checked in our onecare portal or by contacting our TPA Department at 1-855-441-6900.