Humana acquired One Homecare Solutions (onehome)—an integrated home service coordinator for durable medical equipment (DME) and home infusion care. onehome’s model creates one integrated point of accountability that coordinates the needs of patients, physicians, hospitals, facilities, and health plans for DME and home infusion care, alleviating the administrative burden of discharge planning.
onehome will coordinate all orders for DME and home infusion for Humana Medicare Advantage-covered patients under the DME and Home Infusion Programs in VA and NC.
VA counties not included in the programs: Bristol County, Buchanan, Dickenson, Lee, Norton City, Russell, Scott, Smyth, Tazewell, Washington, Wise, Wythe
onehome will secure all prior authorizations directly from Humana, if/as required.
Following review and approval, onehome will manage the fulfillment of approved orders through onehome’s owned DME and home infusion facilities or through DME and home infusion suppliers partnering with Humana and onehome.
Home Infusion and DME suppliers partnering with Humana and onehome refers to those providers that have contractually agreed to participate in the DME and Infusion Program.
Yes. prosthetics, orthotics, and diabetic supplies are not included. Providers should continue to follow their current process to order these items.
onehome does manage DME orders for the following: respiratory, mobility aids, wheelchair and power mobility, beds and support surfaces, colostomy, ostomy, and urological supplies.
If you receive a DME or home infusion order from a referring provider, please direct it to onehome prior to fulfillment. Simply forward the order to onehome via fax: 855-475-5614 and be sure to include the appropriate return fax number with the order.
Services can begin once you receive an approval notification from onehome (excluding prosthetics, orthotics and diabetic supplies).
No, those prior authorizations will be honored and do NOT need to be re-granted except as required under existing procedures.
For instances where onehome is not the servicing provider, onehome will coordinate delivery with DME and home infusion partners.
Once any necessary prior authorization is secured and the order has been approved by onehome, onehome will submit the order to the servicing provider indicated on the order, if one is listed. If there is not a provider listed on the order, onehome will coordinate with a provider participating partners. The order will then be fulfilled and managed by the servicing provider.
There may be a patient out-of-pocket responsibility in the form of a deductible or co-insurance. Out-of-pocket responsibility will be dependent upon the patient’s Humana plan.
onehome has processes in place to ensure that orders for non-covered items are quickly returned to the ordering physician. Processes are set based upon how the order was submitted to onehome. Orders submitted via:
• onehome’s OneCare portal, fax, CarePort or Navi: onehome will review and notify provider within an hour of receipt of the order of any items that cannot be processed by onehome
• Phone: onehome will notify the provider on while on the phone if there are any items that cannot processed
Notify onehome as soon as you are aware that the order cannot be fulfilled to a patient through the OneCare portal, but no later than 24 hours after receipt of order. Reasons for inability to fulfill to patient could be reasons such as patient refused at deliver, unable to reach patient, etc.
onehome will outreach the patient and referring provider once being made aware that an order cannot be fulfilled to try and resolve and barriers of fulfillment
For DME or home infusion services-related questions, call onehome at 833-523-2609 option 3 Monday-Friday 8 a.m. to 9 p.m. EST and Saturday-Sunday 8 a.m. to 5 p.m. EST
For general eligibility/benefits and claims inquiries, contact Humana Medicare Customer Service at 800-457-4708 Monday – Friday 8 a.m. to 8 p.m. EST
Please reference onehome’s provider manual or visit onehome.health for detailed information.
Florida and Texas Servicing Providers
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.