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.

onehome manages all aspects of an order once received. onehome will:

• Seek preauthorization, if necessary, from Humana,
• Coordinate fulfillment either through their facilities or through DME and home infusion providers if onehome cannot fulfill the order or if there is a request for specific provider

onehome is not only a coordinator for DME and home infusion, but also owns DME and home infusion facilities within VA and NC.

onehome can coordinate and service DME and home infusion pharmacy orders effective January 1, 2023.

When onehome is the servicing provider, onehome will:

• Coordinate delivery of equipment and supplies through the ordering physician and/or as part of a patient’s discharge process.
• onehome will also coordinate nursing services for home infusion orders
• Deliver equipment to the hospital, as appropriate, to allow for a safe transition home
• Reach out to patients every month to ensure that equipment is functioning properly and to confirm that the equipment is still needed.
• Pick up unwanted equipment and reuse for new patients if it passes quality standards. This benefits the patient as they will no longer be paying for equipment that is not needed.

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.

As an ordering provider, you will submit DME and home infusion orders directly to onehome for your Humana-covered patients, subject to the exclusions described below.

onehome will receive and review all orders for DME and home infusion and will coordinate directly with Humana to secure any required prior authorization for such orders.

Following review and approval (including prior authorization, as applicable), onehome will arrange the fulfillment of approved orders through onehome’s DME and Infusion facilities or through DME and infusion partners, as applicable.

Your submitted order could be returned to you for the following reasons:

• patient is not in the onehome service area
• item(s) ordered are not in-scope for the DME program managed by onehome,
• the selected physician on the order form is an out-of-network physician
• the patient is not enrolled in a Humana Medicare Advantage HMO or PPO plan,
• patient is paneled to JenCare or Oak Street

If a prior authorization request is denied by Humana, Humana will send written notification to the patient and onehome with the reason for the denial, which will include the contact information and instructions for the appeal process. onehome will notify you, the ordering physician, of the denial.

onehome’s model delivers a seamless process for your patients. Your patients have access to fully coordinated, personalized medical care at home.

Patients paneled to JenCare, or Oak Street are not included in the DME and Home Infusion programs.

Orders can be submitted to onehome in multiple ways:

• Fax: 855-475-5614
• Careport/ECIN: Select “One Homecare Solutions”
• NaviHealth/Curaspan: Select “One Home Medical Equipment” under the “Home Services and Level of Care DME Supplier” section

No, there is not a portal currently available for submitting orders to onehome. Orders can be submitted according to the process outlined above.

Orders will be received by the onehome intake team who will review and determine if authorization is needed for items within the order. Items that will require authorization will be sent to Humana for review. Items that do not require authorization will be fulfilled through onehome owned DME and Infusion facilities or through coordination with DME and home infusion partners. onehome will honor provider or patient preference when fulfilling orders.

onehome’s representatives will outreach, as needed, for reasons such as:

• Obtaining patient demographic and medical history information
• Missing information from orders
• Orders that require clarification
• Notification for when services requested are not covered according to the patient’s health plan guidelines
• Notification of the servicing provider who will be fulfilling the patient’s order.

onehome staff are available after-hours and on weekends to assist you with timely and quality care coordination.

For DME or home infusion services-related questions, call onehome at 833-523-2609

• Liter flow per minute
• Settings route: Nasal cannula; simple mask; or other
• Patient PCP visit date
• Hours of use: Continuous; With exertion; Hours of sleep; bleed into CPAP/Bi-PAP; or other
• Delivery device: Concentrator; Portable cylinders; Conserving device; Liquid; Portable; or other
• Date of saturation test
• Oxygen saturation or PO2 results: %

onehome partners with local home health companies to administer home infusion therapy.

For patients who have been ordered home health or are currently within a home health episode, onehome will partner with the patient’s home health agency to provide the infusion services as part of their home health episode

For patients who do not have a current order for home health, onehome will partner with a local home health company to administer the IV medication.

onehome will notify the ordering physician and the patient once a home health company has accepted the order.

Patients will be provided instructions if they have any questions or concerns surrounding their infusion therapies.

For Medicare Advantage covered-patients, home healthcare aide services are not covered under CMS guidelines when there is no skilled care in the home.

Delivery to the hospital or patient’s home is often within 24-48 hours (or less, based on acuity).
Call onehome at 855-441-6900 for up-to-date status information on DME/infusion deliveries.

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.

For DME or home infusion services-related questions, call onehome at 833-523-2609 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.